Percutaneous ilioinguinal-iliohypogastric nerve block or step-by-step local infiltration anesthesia for inguinal hernia repair: what cadaveric dissection says?.
10.4174/jkss.2011.81.6.408
- Author:
Hakan KULACOGLU
1
;
Zafer ERGUL
;
Ali Firat ESMER
;
Tulin SEN
;
Taylan AKKAYA
;
Alaittin ELHAN
Author Information
1. Department of Surgery, Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey. hakankulacoglu@hotmail.com
- Publication Type:Original Article
- Keywords:
Inguinal hernia;
Local anesthesia;
Infiltration anesthesia;
Nerve block;
Femoral nerve
- MeSH:
Adult;
Anesthesia, Local;
Cadaver;
Femoral Nerve;
Floors and Floorcoverings;
Groin;
Hernia;
Hernia, Inguinal;
Humans;
Male;
Muscles;
Nerve Block;
Skin;
Vas Deferens;
Vision, Ocular
- From:Journal of the Korean Surgical Society
2011;81(6):408-413
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The repair of groin hernias with local anesthesia has gained popularity. Two main methods have been described for local anesthesia. This study was aimed at comparing percutaneous truncular ilioinguinal-iliohypogastric block and step-by-step infiltration technique by using cadaver dissections. METHODS: The study was performed on an adult male cadaver by using blue dye injection. A percutaneous nerve block simulation was done on right side and the dye was given in between the internal oblique and transversus muscles. On the left side, a skin incision was deepened and the dye was injected under the external oblique aponeurosis. Following the injections, stained areas were investigated superficially and within the deeper tissues with dissection. RESULTS: There was a complete superficial staining covering the iliohypogastric and ilioinguinal nerves in the inguinal floor at both sides. On the right side, intraabdominal observation showed a wide and intense peritoneal staining, while almost no staining was seen on the left side. Preperitoneal dissection displayed a massive staining including testicular vascular pedicule and vas deferens on the right side. The dye solution also infiltrated the area of the femoral nerve prominently. On the contrary, a very limited staining was seen on the left. CONCLUSION: It may not always be easy to keep the percutaneous block within optimum anatomical limits without causing adverse events. A step-by-step infiltration technique under direct surgical vision seems to be safer than percutaneous inguinal block for patients undergoing inguinal hernia repair.
