Ilioinguinal-Iliohypogastric Block for Open Inguinal Hernia Repair: A Prospective Observational Study

This study aimed to evaluate the effectiveness of the ultrasound-guided ilioinguinal-iliohypogastric (II-IH) nerve block under mild intravenous sedation as a sole anaesthetic technique for open inguinal hernia repair and to identify factors independently associated with clinical inadequacy. The central research question was whether the II-IH block alone, when combined with intravenous sedation, could provide adequate anaesthesia for this procedure in a day-case setting.

In this prospective observational study conducted at a university hospital, 342 adult patients undergoing unilateral open inguinal hernia repair with II-IH block were enrolled. The primary outcome was a composite of the need for intraoperative opioid supplementation, additional local anaesthetic, or conversion to general anaesthesia. Logistic regression was used to assess predefined predictors of clinical inadequacy.

Out of 342 patients, 233 (68.2%) successfully completed surgery with an II-IH block and mild intravenous sedation as the sole anaesthetic technique. In the remaining 109 patients (31.8%), only 9 (2.6%) required conversion to general anaesthesia. Logistic regression identified anaesthetic volume-but not dose-as significantly associated with clinical inadequacy (P < 0.001).

The II-IH block, when combined with sedation, is a feasible and effective anaesthetic approach for a substantial proportion of appropriately selected patients undergoing open inguinal hernia repair. This approach may represent a practical alternative to spinal or general anaesthesia.