Improved long-lasting postoperative analgesia, recovery function and patient satisfaction after inguinal hernia repair with inguinal field block compared with general anesthesia

Background: Inguinal hernia repair is a common surgical procedure, and different types of anesthetic techniques are in use. We wanted to test if preoperative inguinal field block (IFB) with ropivacaine would provide benefits in the postoperative period compared with general anesthesia and wound infiltration. Methods: Sixty patients scheduled for inguinal hernia repair were randomized to receive general anesthesia with wound infiltration postoperatively, or inguinal field block (IFB) before surgery with no or only light sedation intraoperatively. General anesthesia was induced with midazolam, fentanyl and propofol, maintained with propofol and alfentanil, and supplemented with nitrous oxide in oxygen through a laryngeal mask. The IFB was performed by an anesthesiologist, with 50-60 ml ropivacaine and 5 mg/ml with a dedicated technique. Results: All significant differences were in favor of the IFB group: less pain (visual analog scale, verbal pain score) postoperatively and until day 7, faster mobilization with less pain, lower analgesic consumption, and higher patient satisfaction. Conclusion: Preoperative inguinal field block for hernia repair provides benefits for patients in terms of faster recovery, less pain, better mobilization and higher satisfaction throughout the whole first postoperative week.