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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 Jul 05

DOI: 10.23736/S0375-9393.17.11948-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Ultrasound-guided genitofemoral nerve block for inguinal hernia repair in the male adult: a randomized-controlled pilot study

Luciano FRASSANITO 1 , Bruno A. ZANFINI 1, Sara PITONI 2, Paolo GERMINI 1, Miryam DEL VICARIO 1, Gaetano DRAISCI 1

1 U.O.C. Anestesia in Ostetricia e Day Surgery, Area Anestesiologia Rianimazione Terapie Intensive e Terapia del Dolore, Fondazione Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy; 2 Servizio di Anestesia e Rianimazione, IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy


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BACKGROUND: Ultrasound-guided (USG) ilioinguinal/iliohypogastric nerve (II/IHN) block is a widely validated anesthetic technique for inguinal herniorrhaphy. As the spermatic cord, scrotum, and adjacent thigh receive sensory innervation from the genital branch of genitofemoral nerve (GFN), the addition of GFN block has been suggested to improve the quality of perioperative anesthesia and analgesia. The aim of this study is to compare GFN block plus II/IHN block with II/IHN block alone for intraoperative anesthesia and post-operative pain management.
METHODS: We enrolled 80, ASA I-III, male adults scheduled for elective open herniorrhaphy. Patients were randomized to receive either USG II/IHN plus GFN block (Case Group) or USG II/IHN block alone (Control Group). The outcome measures were the assessment of postoperative VAS scores on coughing and the adequacy of anesthesia, measured with intraoperative requirement for extra local anesthetic (LA) infiltration and number of patients needing systemic sedation.
RESULTS: The requirement of intraoperative additional doses of LA was significantly lower in the Case Group (median LA volume administered by the surgeon: 13.8 ± 5.6 ml vs 20.7 ± 9.1 ml, p<0.05). Two patients in the Control Group needed systemic sedation. VAS scores at 15mins, 30 mins, 1h, 2h, pre-discharge, 24h were significantly lower in the Case Group (p<0.005). Four cases of femoral nerve block were reported, 3 in the Control Group, 1 in the Case Group (2.2% vs 7.7%, p>0.05).
CONCLUSIONS: The combination of GFN block and II/IHN block is associated with lower postoperative VAS scores and lower doses of intraoperative additional LA.


KEY WORDS: Inguinal hernia repair - Regional anesthesia - Genitofemoral nerve

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Publication History

Manuscript first published online: July 05, 2017
Manuscript accepted: June 24, 2017
Manuscript revised: June 8, 2017
Manuscript received: January 18, 2017

Cite this article as

Frassanito L, Zanfini BA, Pitoni S, Germini P, Del Vicario M, Draisci G. Ultrasound-guided genitofemoral nerve block for inguinal hernia repair in the male adult: a randomized-controlled pilot study. Minerva Anestesiol 2017 Jul 05. DOI: 10.23736/S0375-9393.17.11948-6

Corresponding author e-mail

lucfras75@hotmail.com