Evaluation of genitofemoral nerve block, in addition to ilioinguinal and iliohypogastric nerve block, during inguinal hernia repair in children

Background. Ilioinguinal and iliohypogastric (IG-IH) nerve blockhas been widely used in children undergoing inguinal herniarepair. This technique may provide insufficient analgesia forintraoperative management as the inguinal region may receivesensory innervation from genitofemoral nerve. We proposed thataddition of a genitofemoral nerve block might improve the qualityof analgesia. Methods. Ninety-eight children undergoing inguinal hernia repairwere assigned randomly to receive either IG-IH nerve block (GroupI) or IG-IH and genitofemoral nerve blocks (Group II). Systolicarterial pressure (SAP) and heart rate (HR) were recorded beforesurgery (control), after skin incision, at sac traction andat the end of surgery. Postoperative analgesic requirementsand incidence of complications were recorded until discharge. Results. At sac traction, SAP and HR were significantly higherin Group I (P<0.05), and the incidence of episodes of increasedHR was also significantly higher in Group II (29 vs 12%, respectively,P<0.05). There were no significant differences in SAP andHR at other time points, postoperative analgesic requirementsor incidence of complications between the groups. Conclusions. The benefit of the additional genitofemoral nerveblock to IG-IH nerve block was limited only to the time of sactraction without any postoperative effect. This suggests thereis little clinical benefit in the addition of a genitofemoralnerve block.