Percutaneous ilioinguinal-iliohypogastric nerve block or step-by-step local infiltration anesthesia for inguinal hernia repair: what cadaveric dissection says?
Kulacoglu Hakan, Ergul Zafer, Esmer Ali Firat, Sen Tulin, Akkaya Taylan, Elhan Alaittin,
소속 상세정보
( Kulacoglu Hakan )
Turkey Diskapi Yildirim Beyazit Teaching and Research Hospital Department of Surgery
( Ergul Zafer )
Turkey Diskapi Yildirim Beyazit Teaching and Research Hospital Department of Surgery
( Esmer Ali Firat )
Ankara University School of Medicine Department of Anatomy
( Sen Tulin )
Ankara University School of Medicine Department of Anatomy
( Akkaya Taylan )
Turkey Diskapi Yildirim Beyazit Teaching and Research Hospital Department of Anesthesiology
( Elhan Alaittin )
Ankara University School of Medicine Department of Anatomy
KMID : 0371320110810060408
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.
키워드
Inguinal hernia; Local anesthesia; Infiltration anesthesia; Nerve block; Femoral nerve
원문 및 링크아웃 정보
등재저널 정보