Title: Ultrasound guided ilioinguinal & iliohypogastric nerve blocks combined with genital branch of genitofemoral nerve block for open inguinal hernia repair
Authors: Dr Amol A Pandav, Dr Pramod V Bhale
DOI: https://dx.doi.org/10.18535/jmscr/v8i7.105
Abstract
Anesthetic management in patients with preexisting cardiorespiratory disorder is painstaking task with numerous challenges. Most common cause of peri-operative morbidity and mortality in such patients is ischemic heart disease (IHD). Infraumbilical surgeries like hernioplasty are routinely performed under spinal block without much difficulty. However, a patient with cardiac co-morbidities restricts use of certain techniques in anesthesiologist’s armamentarium. Use of neuraxial blockade is prohibited in patients with low ejection fraction, restrictive valvular disease and coagulopathy. Sometimes general anesthesia remains the sole technique of choice to undergo scheduled surgery. This makes the patient bear a wide range of shortcomings like delayed recovery, ICU admission, mechanical ventilation, prolonged hospital stay with economic burden and increased risk of morbidity & mortality. Ilioinguinal nerve and iliohypogastric nerve blocks are very effective techniques in providing anesthesia and postoperative analgesia for inguinal hernia surgeries. We aimed at reducing all the short comings of general anesthesia in three patients undergoing hernioplasty by using ultrasound guided hernia block for intra operative anesthesia. Along with ilioinguinal and iliohypogastric nerve blocks, blocking the genital branch of genitofemoral nerve completes the nerve block for inguinal hernia surgeries.
Keywords: Inguinal hernia, ilioinguinal nerve block, iliohypogastric nerve block, genital branch of genitofemoral nerve.
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