Inguinal Block for Inguinal Hernia Repair in Adults using Tumescent Anaesthesia 0.1% Lignocaine with Adrenaline

Introduction: Inguinal hernia repair is the most common elective surgical procedure performed under general, regional or local anesthesia (LA). The word tumescent means swollen and firm. Klein in 1987 first described tumescent anesthesia for liposuction. Though various concentration, like 0.05, 0.075 and 0.1% have been described there is no such thing as a standard tumescent solution. In this study, we used 0.1% lignocaine with adrenaline for hernia repair under LA. Aims and Objectives: (a) To study the efficacy of illioiguinal, illiohypogastric and genitofemoral nerve blocks in providing intraoperative anesthesia in elective inguinal hernia repair, (b) To study the duration of post- operative analgesia, (c) To study adverse effects if any. Materials and Methods: After obtaining the institutional ethical committee clearance and their written informed consent, 30 male patients who were aged between 18 and 80 years, who belonged to ASA Grade 1 and 2, who were posted for elective inguinal hernia repair surgery were enrolled for the study. An inguinal block was made by blocking illioinguinal, illiohypogastric and genitofemoral nerve after sedation with 20 mg of ketamine. The results were tabulated and analyzed by using appropriate statistical tests. Results: Results of the present study indicates that a tumescent solution of 0.1% lignocaine with adrenaline for inguinal hernia repair (1) prolongs the duration of analgesia, (2) Patients ambulatory period was earlier, (3) No incidence of urinary in-continence. Conclusion: From this study we conclude that inguinal block with 0.1% linguine with adrenaline is an effective alternative for other methods of anesthesia in patients posted for inguinal hernia repair especially in patients with cardiac and respiratory disease where regional and general anesthesia in contraindicated. Good post- operative pain relief is another added advantage.