Ultrasound-guided Ilioinguinal/Iliohypogastric Nerve Block
Condition: Inguinal Hernia Repair; Pain, Postoperative
MeSH terms: Hernia; Pain, Postoperative; Hernia, Inguinal
Study type: Interventional
Phase: Phase 1

Summary: 
      Abdominal wall hernias are common, with a prevalence of 1.7% for all ages and 4% for those
      aged over 45 years. Inguinal hernias account for 75% of abdominal wall hernias, with a
      lifetime risk of 27% in men and 3% in women. Repair of inguinal hernia is one of the most
      common operations in general surgery
    

Detailed description: 
      The peripheral nerve block usage is increasing in popularity because it decreases pain as
      estimated by visual analogue scores/numerical rating pain scores postoperatively and
      decreases the need for postoperative analgesic usage thereby reducing opioid induced side
      effects like postoperative respiratory depression, nausea, vomiting, NSAID induced gastritis
      etc. Nerve blocks also shorten Post-Anesthesia Care Unit stay time, and also increases
      patient satisfaction .

      Ultrasound-guided peripheral nerve blocks including ilioinguinal/ iliohypogastric nerve block
      and transversus abdominis plane block have been widely used and considered as effective
      traditional techniques for postoperative analgesia in inguinal hernia repair .

      In recent years, the quadratus lumborum (QL) block is proposed to be an alternative regional
      block for both upper abdominal surgery and lower abdominal surgery.

      The blockade of ilioinguinal/iliohypogastric nerves in the anterior abdominal wall has
      improved postoperative analgesia after open inguinal hernia repair and many other procedures.

      The Quadratus Lumborum (QL) Block is a regional anesthetic technique which described by
      anesthesiologist "DR Rafael Blanco" in 2007. Quadratus Lumborum block allows the local
      anesthetic agent to spread between the posterior aspect of the Quadratus Lumborum muscle and
      the middle layer of the Thoracolumbar fascia, which is nearer to the thoracic paravertebral
      space. It has four approaches based on the point of drug deposition in relation to quadratus
      lumborum muscle. Drug is deposited on the anterolateral, posterior, anterior to the Quadratus
      Lumborum muscle in the three approaches. In fourth approach drug is deposited
      intramuscularly. It provides postoperative analgesia for longer duration .
    

Intervention name(s): Levo-bupivacaine 0.25
Intervention type(s): Drug
Intervention description(s): The blockade of ilioinguinal/iliohypogastric nerves in the anterior abdominal wall has improved postoperative analgesia after open inguinal hernia repair. Other new blocks needs to be investigated
Intervention MeSH terms: Bupivacaine; Levobupivacaine
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: To investigate the effectiveness of ultrasound guided Ilioinguinal/Iliohypogastric ( II/IH) block compared to ultrasound guided Posterior Quadratus Lumborum (PQL) block in patients subjected to inguinal hernia repair.
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment