Letter to the Editor

Ilioinguinal-Inguinal Nerve Block for Hernia Repair

Authors: Richard K. Baumgarten, MD

Abstract

To the Editor:


A recent article1 and editorial2 describing ilioinguinal-iliohypogastric nerve block (IHNB) for inguinal hernia repair, while thought provoking, is also troubling. The authors have performed a prospective randomized clinical trial (PRCT) and then presented the data as a retrospective study. Patients must grant informed consent to be randomized. A human subject committee (often called an IRB) should review the trialbefore the beginning of the study.

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References

1. Yilmazlar A, Bilgel H, Donmez C, et al. Comparison of ilioinguinal-iliohypogastric nerve block versus spinal anesthesia for inguinal herniorrhaphy. South Med J 2006;99:48–51.
 
2. Wang H. Is ilioinguinal-iliohypogastric nerve block an underused anesthetic technique for inguinal herniorrhaphy? South Med J 2006;99:15.
 
3. Naja MZ, el Hassan MJ, Oweidat M, et al. Paravertebral blockade vs general anesthesia or spinal anesthesia for inguinal hernia repair. Middle East J Anesthesiol 2001;16:201–210.
 
4. Millat B, Borie F, Fingerhut A. Patient’s preference and randomization: new paradigm of evidence-based clinical research. World J Surg 2005;29:596–600.
 
5. Willschke H, Marhofer P, Bosenberg A, et al. Ultrasonography for ilioinguinal/iliohypogastric nerve blocks in children. Br J Anaesth 2005;95:226–230.
 
6. Eichenberger U, Greher M, Kirchmair L, et al. Ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerve: accuracy of a selective new technique confirmed by anatomical dissection. Br J Anaesth 2006;97:238–243.
 
7. Naja ZM, Raf M, El Rajab M, et al. Nerve stimulator-guided paravertebral blockade combined with sevoflurane sedation versus general anesthesia with systemic analgesia for postherniorrhaphy pain relief in children: a prospective randomized trial. Anesthesiology 2005;103:600–605.
 
8. Baumgarten RK, Wesen CA, Boccaccio JE. Regional anesthesia has a role in hernia surgery. World J Surg 2006;30:639–640.
 
9. Baumgarten RK, Greengrass RA, Wesen CA. Paravertebral block: the holy grail of anesthesia for hernia surgery? Anesth Analg 2007;104:207–209.