Combined ilioinguinal blockade and local infiltration anaesthesia for groin hernia repair--a double-blind randomized study.

Author(s): Andersen FH, Nielsen K, Kehlet H

Affiliation(s): Surgical Clinic Charlottenlund, Copenhagen, Denmark.

Publication date & source: 2005-04, Br J Anaesth., 94(4):520-3. Epub 2005 Feb 4.

Publication type: Clinical Trial; Randomized Controlled Trial

BACKGROUND: Local infiltration anaesthesia for inguinal hernia repair is cost-effective, but fear of intra-operative pain may hinder its widespread use. It is unknown whether a combined ilioinguinal blockade and local infiltration anaesthesia improves intra-operative analgesia. METHODS: We performed a double-blind randomized study in 160 patients undergoing inguinal hernia mesh repair under local infiltration anaesthesia with or without additional ilioinguinal blockade. Intra-operative pain and pain at 24 and 48 h postoperatively and analgesic requirements (acetaminophen, ibuprofen, and tramadol) were assessed. RESULTS: Median intra-operative pain scores were reduced (P=0.02) from 13 to 9 with additional ilioinguinal blockade, with no differences in requirement for sedation. There were significantly (P<0.05) more patients with intra-operative visual analogue pain scale >/=30 in the placebo group vs the ilioinguinal blockade group. Postoperative pain scores and analgesic requirements were similar. CONCLUSION: Combined ilioinguinal blockade and local infiltration anaesthesia is recommended for groin hernia repair to reduce intra-operative pain.