Ilioinguinal/Iliohypogastric Block for Inguinal Hernia Repair

Study Overview
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Brief Summary
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Inguinal hernia have traditionally been done under general anesthesia. While safe, general anesthesia is associated with potential postoperative nausea/vomiting and drowsiness. Additionally, the recent COVID19 pandemic has heightened the precaution to avoid aerosol generating procedures (AGP) if possible. General anesthesia requires airway manipulation, thus necessitate performing an AGP. Recently, we began using peripheral nerve block and sedation as primary anesthetic technique for inguinal hernia repairs. While surgeon administered local anesthetic, also known as local infiltration, has been done for inguinal hernia repair, using specific nerve blocks and sedation has not been compared with general anesthesia. We believe the advantage of this novel technique can improve postoperative recovery. This retrospective study will compare the total hospital length of stay of those receiving nerve blocks and sedation as primary anesthetic techniques versus those with general anesthesia.

Official Title
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Postoperative Recovery Time in Inguinal Hernia Repair Under Ilioinguinal, Iliohypogastric Nerve Block and Sedation Versus General Anesthesia: a Propensity Score Matched-cohort Retrospective Study

Conditions
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Anesthesia

Intervention / Treatment
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* Procedure: Regional Anesthesia and Sedation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years or older American Society of Anesthesiologists (ASA) Physical Status I to III Body Mass Index (BMI) less than 45 Single hernia repair, elective, ambulatory surgery Exclusion Criteria: Opioid dependence (30 mg oral morphine equivalents daily or more) History of malignant hyperthermia Pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| General Anesthesia<br>patients received general anesthesia for inguinal hernia repair | |
| Regional Anesthesia and Sedation<br>patients received ilioinguinal/iliohypogastric nerve blocks and sedation for inguinal hernia repair | Procedure: Regional Anesthesia and Sedation<br>* Preoperative ilioinguinal/iliohypogastric nerve block and moderate to deep intraoperative sedation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative recovery time | Time from exiting operating room to time ready for hospital discharge | Time from exiting operating room to time ready for hospital discharge, up to 100 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Preoperative time | Time from patient registration to entering operating room | Time from patient registration to entering operating room, up to 100 hours | 
| Intraoperative time | Time from entering to exiting operating room | Time from entering to exiting operating room, up to 100 hours | 
| Hospital length of stay | Time from patient registration to ready for hospital discharge | Time from patient registration to ready for hospital discharge, up to 100 hours | 
| Postoperative nausea vomiting | Associated symptoms of nausea vomiting, or received non-prophylactic antiemetics | Time from exiting operating room to time ready for hospital discharge, up to 100 hours | 
| Severe pain | Any incidence when patient rated pain at least 7 out of 10 numeric rating scale | Time from exiting operating room to time ready for hospital discharge, up to 100 hours | 
| Desaturation | Oxygen saturation below 90% with or without oxygen | Time from exiting operating room to time ready for hospital discharge, up to 100 hours | 
| Postoperative opioid dose | total postoperative opioid dose in oral morphine equivalents | Time from exiting operating room to time ready for hospital discharge, up to 100 hours |