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. 2014 Oct;8(4):523-8.
doi: 10.4103/1658-354X.140883.

General anesthesia plus ilioinguinal nerve block versus spinal anesthesia for ambulatory inguinal herniorrhapy

Lucía Vizcaíno-Martínez  1 , Manuel Ángel Gómez-Ríos  1 , Beatriz López-Calviño  1
Affiliations

General anesthesia plus ilioinguinal nerve block versus spinal anesthesia for ambulatory inguinal herniorrhapy

Lucía Vizcaíno-Martínez et al. Saudi J Anaesth. 2014 Oct.

Abstract

Objective: The aim was to evaluate general anesthesia (GA) plus ilioinguinal nerve block (IIB) versus spinal anesthesia (SA) in patients scheduled for ambulatory inguinal hernia repair regarding pain management, anesthesia recovery and reducing potential complications.

Materials and methods: A double-blind, prospective, randomized, controlled study in patients American Society of Anesthesiologists I-III randomized into two groups: GA plus IIB group, induction of anesthesia with propofol, maintenance with sevoflurane, airway management with laryngeal mask allowing spontaneous ventilation and ultrasound-guided IIB; SA group, patients who underwent spinal block with 2% mepivacaine. The study variables were pain intensity, assessed by visual analog scale, analgesic requirements until hospital discharge, time to ambulation and discharge, postoperative complications-related to both techniques and satisfaction experienced.

Results: Thirty-two patients were enrolled; 16 patients in each group. The differences regarding pain were statistically significant at 2 h of admission (P < 0.001) and at discharge (P < 0.001) in favor of the GA plus ilioinguinal block group. In addition in this group, analgesic requirements were lower than SA group (P < 0.001), with times of ambulation and discharge significantly shorter. The SA group had a higher tendency to develop complications and less satisfaction.

Conclusion: General anesthesia plus IIB is better than SA regarding postoperative analgesia, time to mobilization and discharge, side-effect profile and satisfaction experienced by the patients.

Keywords: Ambulatory surgical procedures; analgesia; general anesthesia; inguinal hernia; nerve block; pain management; spinal anesthesia.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Ultrasonographic image show the ilioinguinal nerve between the internal oblique and transversus abdominis muscles
Figure 2
Figure 2
CONSORT flow diagram
Figure 3
Figure 3
Pain assessment during the follow-up period
Figure 4
Figure 4
Analgesic requirements
Figure 5
Figure 5
Times to ambulation, discharge and total postoperative stay
See this image and copyright information in PMC

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