Postoperative Analgesic Efficacy Of Ilioinguinal-Iliohypogastric Block In Inguinal Hernia Surgeries: A Prospective Randomized Single-Blind Study

Abstract

Introduction: Ilioinguinal-iliohypogastric (II/IH) nerve block is used for postoperative analgesia in lower abdominal surgeries. We aimed to compare the postoperative analgesic efficacy of ultrasound (US) guided II/IH nerve block, tramadol, and paracetamol in patients scheduled for unilateral inguinal hernia surgery. Materials and Methods: The study population consisted of patients who underwent surgery diagnosed with inguinal hernia. Sixty male cases aged 18-65 years and ASA I-II were included in the study. After spinal anesthesia, those who underwent II/IH nerve block under US guidance for postoperative analgesia were classified as Group B (n=20), those who received tramadol were classified as Group T (n=20), and those who received paracetamol were classified as Group P (n=20). Demographic characteristics, hemodynamic parameters, time before postoperative first analgesic requirement, amount of analgesic used in the first 24 hours, additional analgesic requirement, Visual Analogue Scale (VAS) score, and patient satisfaction were recorded. Results: There was no significant difference between the groups regarding demographic data, ASA score, and operation. Up to 24 hours postoperatively, patient satisfaction in Group B was significantly higher than in the other two groups. While the time before the first analgesic requirement was 295 minutes in Group B, it was 129.5 minutes in Group T and 122 minutes in Group P (p=0.001). While the VAS scores in the first 12 hours postoperatively were lower in Group B, they were similar in all three groups after the 12th hour. Conclusion: The study findings demonstrated II/IH nerve block reduces the need for analgesia in the first 24 hours postoperatively in inguinal hernia operations performed under spinal anesthesia. In addition, it was determined that II/IH nerve block ensures better postoperative patient satisfaction and prolongs the first analgesic requirement time.