Selective regional anesthesia options in surgical subspecialties

These two nerves lie in close proximity to one another and are frequently blocked together with the same needle insertion. Dr. Harvey Cushing reported in the Annals of Surgery in 1900 that “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” [1]. Today, because of infrequent use, some authors claim that the block is underutilized for herniorrhaphy [2]. Recently, Yilmazlar and colleagues compared the ilioinguinal/iliohypogastric nerve blocks to spinal anesthesia for inguinal herniorrhaphy. They found that patients receiving the ilioinguinal/iliohypogastric nerve blocks had shorter time-to-home readiness, quicker oral intake postsurgery, and no need for recovery room care [3].