• F H Andersen, K Nielsen, and H Kehlet.
• Surgical Clinic Charlottenlund, Copenhagen, Denmark.
• Br J Anaesth. 2005 Apr 1;94(4):520-3.

BackgroundLocal infiltration anaesthesia for inguinal hernia repair is cost-effective, but fear of intra-operative pain may hinder its widespread use. It is unknown whether a combined ilioinguinal blockade and local infiltration anaesthesia improves intra-operative analgesia.MethodsWe performed a double-blind randomized study in 160 patients undergoing inguinal hernia mesh repair under local infiltration anaesthesia with or without additional ilioinguinal blockade. Intra-operative pain and pain at 24 and 48 h postoperatively and analgesic requirements (acetaminophen, ibuprofen, and tramadol) were assessed.ResultsMedian intra-operative pain scores were reduced (P=0.02) from 13 to 9 with additional ilioinguinal blockade, with no differences in requirement for sedation. There were significantly (P<0.05) more patients with intra-operative visual analogue pain scale >/=30 in the placebo group vs the ilioinguinal blockade group. Postoperative pain scores and analgesic requirements were similar.ConclusionCombined ilioinguinal blockade and local infiltration anaesthesia is recommended for groin hernia repair to reduce intra-operative pain.

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