Ultrasound-guided Ilioinguinal/Iliohypogastric block with sedation for ambulatory hernia repair: a case series
Luis Felipe Barbosa da Silva, Igor Henrique Santos, Délio Henrique Vieira da Silva, Aline Macêdo Pinheiro, Wallace Andrino da Silva
Abstract
This case series evaluates the clinical feasibility and pain outcomes of ultrasound-guided ilioinguinal and iliohypogastric nerve blocks combined with sedation for ambulatory open inguinal hernia repair. Twenty-five adult patients received 0.75% ropivacaine blocks. All procedures were completed without conversion to general anesthesia, though 48% required supplemental local infiltration. Pain scores observationally declined from a mean of 4.3 at 24 hours to 0.2 at 30 days. The mean hospital stay was 2.04 hours with no major complications. Despite the small sample size and lack of a control group, ultrasound-guided nerve blocks with sedation demonstrated feasibility and safety in our cohort, serving as a potential option for ambulatory repair.
Keywords
References
1. Aiolfi A, Cavalli M, Del Ferraro S, Manfredini L, Bonitta G, Bruni PG, et al. Treatment of Inguinal Hernia. Ann Surg. 2021;274(6):954-61. https://doi.org/10.1097/ SLA.0000000000004735. PMid:33427757.
2. Huerta S, Garza AM. A Systematic Review of Open, Laparoscopic, and Robotic Inguinal Hernia Repair: Management of Inguinal Hernias in the 21st Century. J Clin Med. 2025;14(3):990. https://doi.org/10.3390/ jcm14030990. PMid:39941661.
3. Li L, Pang Y, Wang Y, Li Q, Meng X. Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis. BMC Anesthesiol. 2020;20(1):64. https://doi.org/10.1186/ s12871-020-00980-5. PMid:32156258.
4. Mageed NA, Mamoun M, Moad SS, Zaglool A. Ultrasound-guided Ilioinguinal-Iliohypogastric nerve block in inguinal hernia repair surgery under general anesthesia: a randomized controlled study. Anaest & Sur Open Access J. 2020;2(2):MS. ID.000535. https://doi.org/10.33552/ASOAJ.2020.02.000535.
5. Bærentzen F, Maschmann C, Jensen K, Belhage B, Hensler M, Børglum J. Ultrasound-Guided Nerve Block for Inguinal Hernia Repair: A Randomized, Controlled, Double-Blind Study. Reg Anesth Pain Med. 2012;37(5):502-7. https://doi. org/10.1097/AAP.0b013e31825a3c8a. PMid:22705951.
6. Mainprize M, Svendrovski A, Galant G, Ezer D, Hall R, Paasch C. Ultrasound-guided ilioinguinal-iliohypogastric nerve block with local anesthesia and fentanyl analgesia versus local anesthesia and fentanyl analgesia prior to shouldice inguinal hernia repair in adults: a retrospective matched-pair analysis among 100 individuals. Hernia. 2024;28(5):1849-54. https://doi.org/10.1007/s10029-024-03101-0. PMid:39095663.
7. Andersen FH, Nielsen K, Kehlet H. Combined ilioinguinal blockade and local infiltration anaesthesia for groin hernia repair--a double-blind randomized study. Br J Anaesth. 2005;94(4):520-3. https://doi.org/10.1093/bja/aei083. PMid:15695545.
8. 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. 2018;84(2):189-95. https://doi.org/10.23736/S0375-9393.17.11948-6. PMid:28679199.
9. Lv J, Zhang Q, Zeng T, Li XF, Cui Y. Regional block anesthesia for adult patients with inguinal hernia repair: a systematic review. Medicine (Baltimore). 2022;101(38):e30654. https://doi.org/10.1097/MD.0000000000030654. PMid:36197234.
10. Wong AK, Ng AT. Review of ilioinguinal nerve blocks for ilioinguinal neuralgia post hernia surgery. Curr Pain Headache Rep. 2020;24(12):80. https://doi.org/10.1007/s11916-020-00913-4. PMid:33331965.
11. Gong C, Ye X, Liao Y, Ye P, Zheng T, Zheng X. Hypotension after unilateral versus bilateral spinal anaesthesia: a systematic review with meta-analysis. Eur J Anaesthesiol. 2025;42(3):203-23. https://doi.org/10.1097/EJA.0000000000002098. PMid:39575900.
12. Kim H, Lee S, Koh WU, Cho J, Park SW, Kim KS, et al. Norepinephrine prevents hypotension in older patients under spinal anesthesia with intravenous propofol sedation: a randomized controlled trial. Sci Rep. 2023;13(1):21009. https://doi.org/10.1038/s41598-023-48178-2. PMid:38030738.
13. Liu G, Zhao J, Yuan L, Shi F, Zhang L. Spinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective study. BMC Musculoskelet Disord. 2023;24(1):818. https://doi.org/10.1186/s12891-023-06956-z. PMid:37838709.
Submitted date:
01/28/2026
Accepted date:
07/18/2026
Facebook
LinkedIn
Mendeley
Reddit
Email