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BJA Advance Access published online on February 4, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei083
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org
Accepted November 2, 2004

Clinical Investigation

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

F. H. Andersen 1, K. Nielsen 2, and H. Kehlet 3*

1 Surgical Clinic Charlottenlund, Copenhagen, Denmark
2 Surgical Clinic, Hvidovre, Copenhagen, Denmark
3 Section of Surgical Pathophysiology, Juliane Marie Center 4074, Rigshospitalet, Copenhagen, Denmark

* To whom correspondence should be addressed.
H. Kehlet, E-mail: henrik.kehlet{at}rh.dk


  Abstract

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.

Keywords: anaesthetic techniques, regional, inguinal; anaesthetic techniques, subcutaneous; surgery, hernia.
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