Home > Journals > Minerva Anestesiologica > Past Issues > Minerva Anestesiologica 2018 February;84(2) > Minerva Anestesiologica 2018 February;84(2):189-95

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as

 

ORIGINAL ARTICLE   Freefree

Minerva Anestesiologica 2018 February;84(2):189-95

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 Unit of Obstetrics and Day Surgery Anesthesia, Department of Anesthesiology, Reanimation, Intensive Care, and Pain Therapy, A. Gemelli University Hospital Foundation, Sacro Cuore Catholic University, Rome, Italy; 2 Service of Anesthesia and Reanimation, Burlo Garofolo Institute for Maternal and Child’s Health, Trieste, Italy


PDF


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 15 minutes, 30 minutes, 1 hour, 2 hours, pre-discharge, and 24 hours were significantly lower in the Case Group (P<0.005). Four cases of femoral nerve block were reported, three in the Control Group, one 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 - Herniorrhaphy - Conduction anesthesia - Femoral nerve

top of page