Effectiveness of modified ultrasound-guided ilioinguinal and iliohypogastric nerve blocks for postoperative pain control in transinguinal inguinal hernia repair
Year: 2026
Type: article
Abstract: BACKGROUND: Inguinal hernia repair ranks among the most prevalent surgical interventions worldwide. Effective postoperative pain management is paramount for enhancing patient comfort, facilitating early mobilization and optimizing recovery outcomes. OBJECTIVES: This study aimed to rigorously evaluate the efficacy of a modified ultrasound-guided (USG) lower abdominal nerve block in conjunction with local anesthetic (LA) injection during inguinal hernia surgery in elderly patients. MATERIAL AND METHODS: This prospective cohort study included 50 elderly male patients (mean age 71.84 ±5.56 years) who underwent ultrasound-guided transinguinal hernia surgery from May 2022 to June 2023. Patients were divided into the intervention group (n = 28) and the control group (n = 22). Pain scores were assessed using the visual analogue scale (VAS) multiple times as initial, during and within the first 24 h post-surgery. Secondary outcomes, encompassing vital signs, analgesic consumption and overall patient satisfaction, were also monitored. RESULTS: The mean age of the cohort was 71.84 ±5.56 years, with a mean body mass index (BMI) of 24.96 ±1.59 kg/m2. A substantial proportion of patients (82%) presented with comorbidities, including hypertension and cerebral infarction. The post-surgery VAS score was significantly decreased in both groups in comparison to the pre-group (in the control group: pre vs post Z = -3.494 p = 0.005, in the intervention group: pre vs post Z = -4.373 p ≤ 0.001). The primary VAS scores were at the highest level at admission time in both groups; however, duringand post-VAS scores were significantly lower in the intervention group than in the control group at time points during and after surgery (p < 0.001, U = 610; and p < 0.001, U = 471, respectively). CONCLUSIONS: The implementation of a modified ultrasound-guided lower abdominal nerve block markedly enhances postoperative analgesia, reduces opioid requirements and improves patient satisfaction in elderly patients undergoing transinguinal hernia repair. These findings underscore the importance of effective pain management strategies in this vulnerable population.
DOI: 10.17219/acem/205614
Authors: Yanping Zhang, Ning Zhang, Guanjun Li
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $754
OpenAlex ID: W7129071454
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