Ultrasound-Guided Nerve Block for Inguinal Hernia Repair

Abstract

Ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerves resulted in a statistically significant and clinically relevant reduction in postoperative pain in the PACU both at mobilization and at rest.

Essentials of Our Current Understanding

“…In the setting of adult inguinal hernia repair, the addition of a US-guided II-IH block to an analgesic regimen of intraoperative morphine and wound infiltration resulted in superior analgesia in the early postoperative period. 164 …”

Abdominal Surgery: Advances in the Use of Ultrasound-Guided Truncal Blocks for Perioperative Pain Management

“…Pain at rest was similarly reduced in the active group at the time of discharge. Most importantly, patients with severe (NRS>5) and moderate (NRS>3) pain at mobilization and rest, respectively, were significantly reduced in the group of patients having the block (Baerentzen 2012). Thus, it would seem that the USG IIN/IHN block also has a place in the post-and perioperative pain management in adult patients.…”

“…The tip of the needle is placed in this plane, and the spread of the injectate should be observed to expand in the fascial neurovascular plane (3). Traditional techniques were landmark-based and relied on one or two facial "clicks", but the old techniques are largely abandoned now, since US imaging subsequent to the so-called blind blocks has demonstrated incorrect placement of the local anaesthetic administered (Weintraud 2008 (Baerentzen 2012). The pain scores were recorded when the patients arrived at the post anaesthesia care unit (PACU) and after 30 minutes stay.…”

Bloqueio dos nervos ílio‐hipogástrico/ilioinguinal em correção de hérnia inguinal para tratamento da dor no pós‐operatório: comparação entre a técnica de marcos anatômicos e a guiada por ultrassom

“…Baerentzen et al 50 avaliaram a eficácia do bloqueio dos nervos IH/II com US em 60 casos, estado físico ASA I-II, acima de 18 anos, submetidos à herniorrafia inguinal unilateral. Após a indução da anestesia geral, o bloqueio do nervo IH/II guiado por US foi feito com bupivacaína ou salina.…”