Ilioinguinal, Iliohypogastric and Genitofemoral Nerve Block for Elderly Patients Undergoing Inguinal Hernia Surgery in a Tertiary Care Center

Authors

  • Rupesh Kumar Yadav Department of Anaesthesiology, Critical Care and Pain Medicine, National Trauma Center, National Academy of Medical Sciences, Mahaboudha, Kathmandu, Nepal.
  • Tshering Sherpa Department of Anaesthesiology, Critical Care and Pain Medicine, National Trauma Center, National Academy of Medical Sciences, Mahaboudha, Kathmandu, Nepal.
  • Nabin Pokhrel Department of Anaesthesiology, Critical Care and Pain Medicine, National Trauma Center, National Academy of Medical Sciences, Mahaboudha, Kathmandu, Nepal.
  • Pawan Kumar Hamal Department of Anaesthesiology, Critical Care and Pain Medicine, National Trauma Center, National Academy of Medical Sciences, Mahaboudha, Kathmandu, Nepal. https://orcid.org/0000-0003-4887-3487
  • Anuj Jung Rayamajhi Department of Anaesthesiology, Civil Service Hospital, Min Bhawan Kathmandu, Nepal.
  • Prajwal Raj Bhattarai Department of Anaesthesiology, Civil Service Hospital, Min Bhawan Kathmandu, Nepal.
  • Subash Chandra Paudel Department of Anaesthesiology, Civil Service Hospital, Min Bhawan Kathmandu, Nepal.
  • Prashanta Paudel Department of Anaesthesiology, Civil Service Hospital, Min Bhawan Kathmandu, Nepal.
  • Suresh Prasad Nepal Department of General Practice and Emergency Medicine, National Academy of Medical Sciences, Mahaboudha, Kathmandu, Nepal. https://orcid.org/0009-0007-8710-9234

DOI:

https://doi.org/10.56974/pmjn.208

Keywords:

iliohypogastric nerve, ilioinguinal nerve, inguinal hernia, nerve block, ultrasound.

Abstract

Introduction: Inguinal hernia is one of the common surgical procedures performed. The choice of anaesthesia may vary from general, spinal, and local infiltration to ultrasound-guided regional anaesthesia. Ultrasound-guided ilioinguinal/iliohypogastric nerve and genital branch of the genitofemoral nerve can be blocked precisely providing adequate surgical anesthesia and little variation in hemodynamics in elderly patients. This study aims to study the intraoperative hemodynamic changes in elderly patients who had comorbid conditions and were undergoing inguinal hernia repair under ilioinguinal, iliohypogastric and genitofemoral nerve block.

Methods: A retrospective chart review was conducted to see changes in intraoperative hemodynamics in 88 elderly patients with one or more comorbidities in comparison to the baseline hemodynamics. Systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate were recorded every 5 minutes intraoperatively and compared to the baseline values. Students paired t-tests were used to compare systolic, diastolic, mean arterial pressure and heart rate at fixed interval records during the surgery.

Results: The mean age of patients in our study was 70.34 ± 9.33 years. There were no significant changes (p-value less than 0.05) in the systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate taken at different time intervals compared to the baseline value.

Conclusions: Ultrasound-guided ilioinguinal/iliohypogastric nerve and genital branch of the genitofemoral nerve can be blocked providing adequate surgical anaesthesia and minimal variation in hemodynamics in elderly patients.

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Published

2024-09-30

Issue

Vol. 24 No. 3 (2024): PMJN

Section

Original Articles