Comparative Study between Ultrasound Guided Quadratus Lumborum versus Ilioingunial/Iliohypogastric Nerves Block as Post-Operative Analgesia for Patients Undergoing Inguinal Hernia Repair Surgeries

Abstract

Abstract Background Poorly controlled acute pain after abdominal surgery is related to somatic pain signals derived from the abdominal wall and is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, delirium, myocardial ischemia, prolonged hospital stay, an increased likelihood of chronic pain, increased consumption of analgesics, delayed bowel function and increase the requirement for rescue analgesics. Appropriate pain treatment protocols to reduce postoperative morbidity, improve the results of the surgery and decrease hospital costs. Aim of the Work The aim of this study was to assess the analgesic efficacy of ultrasound-guided trans- muscular QLB compared with ilioinguinal-iliohypogastric nerve block in the postoperative period after inguinal hernia repair surgeries regarding pain relief, provision of comfort, and improved respiratory functions. Patients and Methods After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, patients were divided into two groups (n = 22; each); group QLB and group ILI/IHG. Results The present study showed that the quadratus lumborum block was more efficient than the ilioinguinal-iliohypogastric nerves block. The first rescue for analgesia (pethidine), total pethidine consumption and pain scores (Numerical Rating Scale) indicated that the superiority of the quadratus lumborum block technique affected the ilioinguinal-iliohypogastric nerves block technique. The patients of group ilioinguinal-iliohypogastric nerves block had higher pain scores and were the first to ask for rescue analgesia; therefore, they had highest total pethidine consumption in the first 24 hours postoperatively in comparison to patients of group quadratus lumborum block. Regarding NRS score postoperatively, our study found that NRS score was significantly lower in group A when compared with group B. Conclusion Quadratus Lumborum block was the most effective technique in providing analgesia after inguinal hernia repair surgeries in comparison to Ilioinguinal/Iliohypogastric nerves block and even more time covering to rescue opioid.