Ilioinguinal-Iliohypogastric Block for Open Inguinal Hernia Repair: A Prospective Observational Study

Objective: This study aimed to evaluate the effectiveness of the ultrasound-guided ilioinguinal-iliohypogastric (II-IH) nerve block under mild intravenous sedation as a sole anaesthetic technique for open inguinal hernia repair and to identify factors independently associated with clinical inadequacy. The central research question was whether the II-IH block alone, when combined with intravenous sedation, could provide adequate anaesthesia for this procedure in a day-case setting. Methods: In this prospective observational study conducted at a university hospital, 342 adult patients undergoing unilateral open inguinal hernia repair with II-IH block were enrolled. The primary outcome was a composite of the need for intraoperative opioid supplementation, additional local anaesthetic, or conversion to general anaesthesia. Logistic regression was used to assess predefined predictors of clinical inadequacy. Results: Out of 342 patients, 233 (68.2%) successfully completed surgery with an II-IH block and mild intravenous sedation as the sole anaesthetic technique. In the remaining 109 patients (31.8%), only 9 (2.6%) required conversion to general anaesthesia. Logistic regression identified anaesthetic volume—but not dose—as significantly associated with clinical inadequacy (P < 0.001). Conclusion: The II-IH block, when combined with sedation, is a feasible and effective anaesthetic approach for a substantial proportion of appropriately selected patients undergoing open inguinal hernia repair. This approach may represent a practical alternative to spinal or general anaesthesia.