Ultrasound-Guided Ilioinguinal/Iliohypogastric Nerve Blocks Versus Transversus Abdominis Plane Block As Analgesia For Inguinal Hernia Repair

Objectives: Evaluation of ultrasound guided (USG) ilioinguinal/iliohypogastric (II/IH) nerve block versus USG transversus abdominis plane (TAP) block as analgesia for adults undergoing inguinal hernia repair. The analgesic efficacy was assessed by visual analogue scale (VAS) as primary objective. Time to first rescue analgesia, postoperative consumption of additional analgesics, hemodynamics, and complications were assessed as secondary objectives. Background: USG II/IH nerve block and TAP block are getting more consideration as a potent analgesia for effective pain management. Methods: A prospective randomized controlled trial included 60 adult patients scheduled for elective inguinal hernia repair under general anesthesia. The participants were assigned into two equal groups (30 patients each). Group A received USG TAP block (posterior approach). Group B received USG II/IH nerve block. Results: VAS score was lower in group A than group B with statistical significance on admission to post anesthesia care unit, 1.5, 8, 18, and 24 hours postoperatively with P value = 0.004, 0.042, 0.048, 0.003, 0.004, respectively. Time to first rescue analgesia was significantly longer in group A than group B (377.7±157.1 vs. 312.6±69.47 minutes) (P value = 0.042). Total postoperative diclofenac consumption and the number of patients who needed intravenous meperidine were comparable between both groups. Conclusion: This study showed that TAP block is superior to II/IH nerve block as analgesia after inguinal hernia repair with less postoperative analgesics consumption and delaying need for rescue analgesia.