Percutaneous ilioinguinal-iliohypogastric nerve block or step-by-step local infiltration anesthesia for inguinal hernia repair: what cadaveric dissection says?


Kulacoglu H., Ergul Z., ESMER A. F., ŞEN ESMER T., Akkaya T., Elhan A.

JOURNAL OF THE KOREAN SURGICAL SOCIETY, cilt.81, sa.6, ss.408-413, 2011 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 81 Sayı: 6
  • Basım Tarihi: 2011
  • Doi Numarası: 10.4174/jkss.2011.81.6.408
  • Dergi Adı: JOURNAL OF THE KOREAN SURGICAL SOCIETY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED)
  • Sayfa Sayıları: ss.408-413
  • Anahtar Kelimeler: Inguinal hernia, Local anesthesia, Infiltration anesthesia, Nerve block, Femoral nerve, ILIOINGUINAL/ILIOHYPOGASTRIC BLOCKS, CHILDREN, HERNIORRHAPHY, ULTRASOUND, LICHTENSTEIN, MANAGEMENT
  • Ankara Üniversitesi Adresli: Evet

Özet

Purpose: The repair of groin hernias with local anesthesia has gained popularity. Two main methods have been described for local anesthesia. This study was aimed at comparing percutaneous truncular ilioinguinal-iliohypogastric block and step-by-step infiltration technique by using cadaver dissections. Methods: The study was performed on an adult male cadaver by using blue dye injection. A percutaneous nerve block simulation was done on right side and the dye was given in between the internal oblique and transversus muscles. On the left side, a skin incision was deepened and the dye was injected under the external oblique aponeurosis. Following the injections, stained areas were investigated superficially and within the deeper tissues with dissection. Results: There was a complete superficial staining covering the iliohypogastric and ilioinguinal nerves in the inguinal floor at both sides. On the right side, intraabdominal observation showed a wide and intense peritoneal staining, while almost no staining was seen on the left side. Preperitoneal dissection displayed a massive staining including testicular vascular pedicule and vas deferens on the right side. The dye solution also infiltrated the area of the femoral nerve prominently. On the contrary, a very limited staining was seen on the left. Conclusion: It may not always be easy to keep the percutaneous block within optimum anatomical limits without causing adverse events. A step-by-step infiltration technique under direct surgical vision seems to be safer than percutaneous inguinal block for patients undergoing inguinal hernia repair.