Ilioinguinal/Iliohypogastric Block for Inguinal Hernia Repair

Postoperative Recovery Time in Inguinal Hernia Repair Under Ilioinguinal, Iliohypogastric Nerve Block and Sedation Versus General Anesthesia: a Propensity Score Matched-cohort Retrospective Study

Inguinal hernia have traditionally been done under general anesthesia. While safe, general anesthesia is associated with potential postoperative nausea/vomiting and drowsiness. Additionally, the recent COVID19 pandemic has heightened the precaution to avoid aerosol generating procedures (AGP) if possible. General anesthesia requires airway manipulation, thus necessitate performing an AGP. Recently, we began using peripheral nerve block and sedation as primary anesthetic technique for inguinal hernia repairs. While surgeon administered local anesthetic, also known as local infiltration, has been done for inguinal hernia repair, using specific nerve blocks and sedation has not been compared with general anesthesia. We believe the advantage of this novel technique can improve postoperative recovery. This retrospective study will compare the total hospital length of stay of those receiving nerve blocks and sedation as primary anesthetic techniques versus those with general anesthesia.

Study Overview

• Status: Not yet recruiting
• Conditions: Anesthesia
• Intervention / Treatment: Procedure: Regional Anesthesia and Sedation

• Study Type: Observational
• Enrollment (Anticipated): 350

Contacts and Locations

• Study Contact: Name: Cheng Lin; Phone Number: 5196858600; Email: cheng.lin@lhsc.on.ca

Study Locations

• Canada
  • Ontario
    • London, Ontario, Canada, n6c6a7
      • Cheng Lin
      • Contact: Cheng Lin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patient

Description

Inclusion Criteria:

• 18 years or older
• American Society of Anesthesiologists (ASA) Physical Status I to III
• Body Mass Index (BMI) less than 45
• Single hernia repair, elective, ambulatory surgery

Exclusion Criteria:

• Opioid dependence (30 mg oral morphine equivalents daily or more)
• History of malignant hyperthermia
• Pregnancy

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
General Anesthesia; patients received general anesthesia for inguinal hernia repair
Regional Anesthesia and Sedation; patients received ilioinguinal/iliohypogastric nerve blocks and sedation for inguinal hernia repair	Procedure: Regional Anesthesia and Sedation; Preoperative ilioinguinal/iliohypogastric nerve block and moderate to deep intraoperative sedation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative recovery time	Time from exiting operating room to time ready for hospital discharge	Time from exiting operating room to time ready for hospital discharge, up to 100 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Preoperative time	Time from patient registration to entering operating room	Time from patient registration to entering operating room, up to 100 hours
Intraoperative time	Time from entering to exiting operating room	Time from entering to exiting operating room, up to 100 hours
Hospital length of stay	Time from patient registration to ready for hospital discharge	Time from patient registration to ready for hospital discharge, up to 100 hours
Postoperative nausea vomiting	Associated symptoms of nausea vomiting, or received non-prophylactic antiemetics	Time from exiting operating room to time ready for hospital discharge, up to 100 hours
Severe pain	Any incidence when patient rated pain at least 7 out of 10 numeric rating scale	Time from exiting operating room to time ready for hospital discharge, up to 100 hours
Desaturation	Oxygen saturation below 90% with or without oxygen	Time from exiting operating room to time ready for hospital discharge, up to 100 hours
Postoperative opioid dose	total postoperative opioid dose in oral morphine equivalents	Time from exiting operating room to time ready for hospital discharge, up to 100 hours

Collaborators and Investigators

• Sponsor: Lawson Health Research Institute

Study record dates

Study Major Dates

• Study Start (ANTICIPATED): May 1, 2022
• Primary Completion (ANTICIPATED): June 1, 2022
• Study Completion (ANTICIPATED): July 1, 2022

Study Registration Dates

• First Submitted: April 9, 2022
• First Submitted That Met QC Criteria: April 14, 2022
• First Posted (ACTUAL): April 19, 2022

Study Record Updates

• Last Update Posted (ACTUAL): April 19, 2022
• Last Update Submitted That Met QC Criteria: April 14, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathological Conditions, Anatomical; Hernia, Abdominal; Hernia; Hernia, Inguinal; Physiological Effects of Drugs; Central Nervous System Depressants; Anesthetics
• Other Study ID Numbers: 119564

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No