Hernia : the journal of hernias and abdominal wall surgery
Perineural versus intravenous dexmedetomidine as an adjuvant for ilioinguinal/iliohypogastric nerve block in open inguinal hernia repair: a randomised controlled trial
By Pisutchareonpong P, Chumthong C, Sirimanakul N and 9 others.
Abstract
Purpose
Dexmedetomidine is widely added to peripheral nerve blocks, but whether the perineural or intravenous route provides better analgesia-and at what haemodynamic cost-is unclear in inguinal hernia repair. We compared the two routes as adjuncts to an ilioinguinal/iliohypogastric (II/IH) nerve block.
Methods
This single-centre, triple-blind randomised controlled trial enrolled 90 adults (ASA I-III) undergoing elective open inguinal hernia repair. All received an ultrasound-guided II/IH block (0.5% bupivacaine with epinephrine, 20 mL) and standardised tumescent local anaesthesia, and were randomised 1:1:1 to perineural dexmedetomidine 1 µg/kg (DexLA), intravenous dexmedetomidine 1 µg/kg over 10 min (DexIV), or placebo (Control). The primary outcome was movement-evoked visual analogue scale (VAS, 0-100) pain at 6 h, analysed by intention-to-treat.