Analgesic efficacy of ultrasound-guided erector spinae plane block versus ilioinguinal/iliohypogastric nerve block in patients undergoing unilateral inguinal hernia meshplasty – A randomised comparative study

Aims and Objectives: Numerous analgesic approaches have been explored to reduce pain after open mesh hernioplasty. Ultrasound-guided ilioinguinal-iliohypogastric nerve(IIN/IHN) and erector spinae plane (ESP) blocks have been used to enhance pain relief following hernia surgery. This study was done to ascertain which of the two interfascial plane blocks is a better modality for providing post-operative pain relief in patients undergoing mesh hernioplasty. Material and Methods: After written informed consent, 35 patients in the age group of 18-65 years belonging to American Society of Anesthesiologists (ASA) physical status class I and II, scheduled to undergo unilateral hernia meshplasty, were included in the present study. The patients were randomised to receive either ultrasound-guided IIN/IHN or ESP block at the end of spinal anaesthesia injection and before starting the surgical procedure. The two study arms were evaluated for post-operative visual analogue scale (VAS) score at rest and movement, time to initial rescue analgesia, cumulative morphine consumption in the post-operative period, post-operative nausea and vomiting, and safety profile of the blocks. All the observations were subjected to appropriate statistical analysis (p-value> 0.05 as significant). Results: Patients in the ESP block group exhibited better pain scores at rest and on movement, longer time to first rescue analgesia, and lower opioid consumption. No adverse effects of the block were observed in either group. Conclusion: Ultrasound-guided ESP block provides more effective analgesia as compared to IIN/IHN block.