Ultrasound Guided Ilioinguinal and Iliohypogastric Nerve Blocks for Post Operative Analgesia in Unilateral Inguinal Hernia Surgeries Under Spinal Anaesthesia

Background: Inguinal hernioplasty is one of the most common elective surgeries done worldwide nowadays as a day care procedure .Management of acute post opearative pain is necessary to decrease patient morbidity,hospital stay and improve patient satisfaction.Ultrasound guided peripheral nerve blocks offer effective pain relief with minimal systemic effects. However, there's limited research on the use of ultrasoundguided nerve blocks with 0.5% ropivacaine for postoperative pain relief and hence this study. This Objective: study was done to evaluate the effect of ultrasound guided ilioinguinal and iliohypogastric nerve blocks with 0.5% ropivacaine on post operative analgesia and subsequent opioid requirements in patients undergoing unilateral open inguinal hernia surgeries under spinal anaesthesia. Methodology: In this study, 82 patients in either sex between 20-60 years of age scheduled for unilateral open inguinal hernia repair under spinal anesthesia were included. 41 patients,(groupA) received ilioinguinal and iliohypogastric nerve blocks with 10ml of 0.5% ropivacaine under ultrasound guidance after wound closure. Remaining 41 patients,(GroupB) did not receive any nerve blocks. Patient were shifted to post operative ward and following parameters(time to rescue analgesia, Visual analogue scale(VAS) at rest and movement, total opioids consumed,post operative nausea and vomiting impact scale,Ramsay's sedation score,Modied Aldrete score) were monitored at 0,30,60minutes,2,4,6,12 and 24 post operative hours and compared between the two groups. Time to rescue analgesia in group A was signicantly higher wh Results: en compared to groupB(p <0.001). VAS score at rest was signicantly less in group A starting at 2hours and continued till 12 hours post operatively (p<0.05). VAS at movement was signicantly less up to 6 hours in the post operative period in group A(p<0.05). Total opioid consumption in group A was signicantly less after 24 hours(p<0.05).A highly signicant reduction in opioid consumption was seen during the initial 6 hours of post operative period(p<0.001).There was a signicant reduction in the incidence of nausea, vomiting and sedation in group A during the initial 6 hours of post operative period (p<0.05).Patients in group A showed an early recovery and discharge from PACU in the initial 6 hours post operatively. Conclusion: This study concluded that ilioinguinal iliohypogastric nerve block with 0.5% ropivacaine at the time of wound closure after inguinal hernioplasty provided superior, longer lasting post operative pain relief which reduces the post operative opioid consumption and the side effects associated with it.