Article Text

Download PDFPDF
Ultrasound-Guided Nerve Block for Inguinal Hernia Repair: A Randomized, Controlled, Double-Blind Study
  1. Finn Bærentzen, MD*,
  2. Christian Maschmann, MD*,
  3. Kenneth Jensen, MD, BBA*,
  4. Bo Belhage, MD, DMSc*,
  5. Margaret Hensler, MD and
  6. Jens Børglum, MD, PhD, MBA*
  1. From the Departments of *Anesthesiology and Intensive Care Medicine and
  2. Surgery, Copenhagen University Hospital: Bispebjerg, Copenhagen, Denmark.
  1. Address correspondence to: Jens Børglum, MD, PhD, MBA, Department of Anesthesia and Intensive Care Medicine, Copenhagen University Hospital: Bispebjerg, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark (e-mail: jens.borglum{at}


Background and Objectives Open inguinal hernia repair in adults is considered a minor surgical procedure but can be associated with significant pain. We aimed to evaluate acute postoperative pain management in male adults randomized to receive an ultrasound-guided ilioinguinal and iliohypogastric nerve block administered before surgery, in addition to a standard analgesic regimen.

Methods Sixty patients were included in this randomized, controlled, and double-blind study. Patients were randomized to the administration of a block with 20 mL bupivacaine 0.5% or a placebo block with 20 mL saline. The primary outcome measure was pain at mobilization in the postanesthesia care unit (PACU). Pain at rest, dermatomal anesthesia, time spent in the PACU/ward, opioid consumption, postoperative vomiting and nausea, ability to perform activities of daily living, and perceived ill health status were secondary outcomes.

Results A significant reduction in pain scores at mobilization (P<0.001) and rest (P < 0.005) was recorded in the bupivacaine group upon arrival in the PACU and again after 30 minutes. Pain at rest was similarly reduced in the bupivacaine group at the time of discharge (P < 0.017). There were significantly fewer patients (P < 0.05) with severe (numerical rating scale >5) and moderate (numerical rating scale >3) pain at mobilization and rest, respectively. Opioid consumption and time spent in the PACU were not significantly different between groups.

Conclusions Ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerves resulted in a statistically significant and clinically relevant reduction in postoperative pain in the PACU both at mobilization and at rest.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • This study was financed by the Department of Anesthesia and Intensive Care Medicine, Copenhagen University Hospital: Bispebjerg, Denmark.

  • A restricted few and selected preliminary data have been presented by Dr Bærentzen et al at the 30th ESRA meeting in Dresden, Germany, September 7–10, 2011, and at the annual DASAIM meeting, Copenhagen, Denmark, November 2011.