“Almost all cases of hernia, with the possible exception of those in
young children, could undoubtedly be subjected to the radical operation
under local anesthesia.” This quote by Harvey Cushing reported in the
Annals of Surgery in 1900 illustrates that over 100 years ago the attributes of regional
anesthesia for lower abdominal and inguinal surgery were appreciated.
Ilioinguinal and iliohypogastric blocks are among the most frequently used
regional blocks performed for these surgical procedures. Postherniorrhaphy
pain is moderate to severe and often poorly controlled with opioids as
single modal therapy.1 Ilioinguinal and iliohypogastric
blocks have been shown to significantly reduce pain associated with
herniorrhaphy, regardless of whether the blocks are used as the primary
anesthetic2 or for pain control after
general3,4 or spinal5 anesthesia.