{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T21:55:14Z","timestamp":1781387714907,"version":"3.54.1"},"reference-count":23,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2020,8,13]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Open inguinal herniorrhaphy (OIH) is a commonly performed surgical procedure with expected postoperative pain. Historically, an option for regional analgesia has been an ilioinguinal and iliohypogastric nerve block (IINB). More recently, the transmuscular quadratus lumborum block (QLB) has been used as an analgesic technique for a variety of abdominal and truncal surgical procedures. Given our own institutional experiences with the performance of QLB combined with the body of literature supporting the proximal blockade of the ilioinguinal and iliohypogastric nerves via this approach, we compared the analgesia provided by an IINB to a QLB. We hypothesized that the two blocks would provide equivalent analgesia, as defined by a difference of less than\u00b12 points on the pain scale (0\u201310 numeric rating scale (NRS)), for patients undergoing OIH.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Sixty patients scheduled for elective outpatient OIH under general anesthesia were randomized to preoperatively receive either an IINB or a transmuscular QLB with 0.25% bupivacaine\/epinephrine\/clonidine for postoperative analgesia. The primary endpoint was movement NRS pain scores at 8\u2009hours. Secondary outcomes included resting NRS pain scores at 8 and 24\u2009hours, movement NRS pain scores at 24\u2009hours, incidence of opioid related side effects (nausea, vomiting, pruritus), time-to-first oral opioid analgesic, and total opioid consumption at 24\u2009hours.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifty-nine patients were analyzed per an intention-to-treat approach (one patient was excluded because the surgical procedure was canceled). Movement pain scores at 8\u2009hours were equivalent (IINB 5.10\u00b13.02\u2009vs QLB 5.03\u00b13.01 (mean NRS\u00b1SD); two one-sided test mean difference (90%\u2009CI), 0.07 (\u22121.24 to 1.38), p \u22640.01). There were no differences between groups for any of the secondary endpoints.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>An IINB and a transmuscular QLB are equivalent with regards to their ability to provide postoperative analgesia after OIH.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2020-101571","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T11:24:19Z","timestamp":1601551459000},"page":"970-974","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Ilioinguinal\/Iliohypogastric versus quadratus lumborum nerve blockade for elective open inguinal herniorrhaphy: a prospective, randomized, double-blinded, equivalency trial"],"prefix":"10.1136","volume":"45","clinical-trial-number":[{"clinical-trial-number":"nct03007966","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Christopher J","family":"Edwards","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S","family":"Weller","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean W","family":"Dobson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Douglas","family":"Jaffe","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Wells","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daryl S","family":"Henshaw","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,1]]},"reference":[{"key":"2025101112502383000_45.12.970.1","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1001\/jamasurg.2013.3189","article-title":"Operative management of refractory neuropathic inguinodynia by a laparoscopic retroperitoneal approach","volume":"148","author":"Chen","year":"2013","journal-title":"JAMA Surg"},{"key":"2025101112502383000_45.12.970.2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1998.00864.x"},{"key":"2025101112502383000_45.12.970.3","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200403000-00034"},{"key":"2025101112502383000_45.12.970.4","unstructured":"Malangoni MA , Rosen MJ . Hernias. In: Townsend CMJ , Beauchamp RD , Evers BM , et al , eds. Sabiston textbook of surgery: the biological basis of modern surgical practice. 20th edn. Philadelphia, PA: Elsevier, 2017: 1092\u2013119 .."},{"key":"2025101112502383000_45.12.970.5","first-page":"41","article-title":"Postoperative analgesic efficacy of ultrasound-guided ilioinguinal-iliohypogastric nerve block compared with medial transverse abdominis plane block in inguinal hernia repair: a prospective, randomised trial","volume":"38","author":"Bhatia","year":"2019","journal-title":"Anaesth Crit Care Pain Med"},{"key":"2025101112502383000_45.12.970.6","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1136\/rapm-00115550-199015030-00005","article-title":"Preoperative percutaneous ilioinguinal and iliohypogastric nerve block with 0.5% bupivacaine for post-herniorrhaphy pain management in adults","volume":"15","author":"Bugedo","year":"1990","journal-title":"Reg Anesth"},{"key":"2025101112502383000_45.12.970.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.rapm.2007.02.002"},{"key":"2025101112502383000_45.12.970.8","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000299"},{"key":"2025101112502383000_45.12.970.9","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000495"},{"key":"2025101112502383000_45.12.970.10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jclinane.2017.05.015","article-title":"Evaluation of ultrasound-guided posterior quadratus lumborum block for postoperative analgesia after laparoscopic gynecologic surgery","volume":"41","author":"Ishio","year":"2017","journal-title":"J Clin Anesth"},{"key":"2025101112502383000_45.12.970.11","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1213\/ANE.0000000000002648","article-title":"The analgesic effect of ultrasound-guided quadratus lumborum block after cesarean delivery: a randomized clinical trial","volume":"126","author":"Krohg","year":"2018","journal-title":"Anesth Analg"},{"key":"2025101112502383000_45.12.970.12","doi-asserted-by":"crossref","first-page":"89","DOI":"10.5603\/GP.a2018.0015","article-title":"Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section - a controlled clinical study","volume":"89","author":"Mieszkowski","year":"2018","journal-title":"Ginekol Pol"},{"key":"2025101112502383000_45.12.970.13","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000645"},{"key":"2025101112502383000_45.12.970.14","doi-asserted-by":"crossref","unstructured":"B\u00f8rglum J , Moriggl B , Jensen K , et al . Ultrasound-Guided transmuscular quadratus lumborum blockade. Br J Anaesth 2013;111.doi:10.1093\/bja\/el_9919","DOI":"10.1093\/bja\/el_9919"},{"key":"2025101112502383000_45.12.970.15","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000411"},{"key":"2025101112502383000_45.12.970.16","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/anae.13647","article-title":"A radiologic and anatomic assessment of injectate spread following transmuscular quadratus lumborum block in cadavers","volume":"72","author":"Adhikary","year":"2017","journal-title":"Anaesthesia"},{"key":"2025101112502383000_45.12.970.17","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1097\/EJA.0000000000000680","article-title":"Injectate spread following anterior sub-costal and posterior approaches to the quadratus lumborum block: a comparative cadaveric study","volume":"34","author":"Elsharkawy","year":"2017","journal-title":"Eur J Anaesthesiol"},{"key":"2025101112502383000_45.12.970.18","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/s12630-017-1021-y","article-title":"Ultrasound-Guided lateral-medial transmuscular quadratus lumborum block for analgesia following anterior iliac crest bone graft harvesting: a clinical and anatomical study","volume":"65","author":"Sondekoppam","year":"2018","journal-title":"Can J Anaesth"},{"key":"2025101112502383000_45.12.970.19","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei157"},{"key":"2025101112502383000_45.12.970.20","unstructured":"McPherson ML . Demystifying Opioid Conversion Calculations: A Guide for Effective Dosing. Bethesda, MD: American Society of Health-System Pharmacists, 2010."},{"key":"2025101112502383000_45.12.970.21","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(03)00162-3"},{"key":"2025101112502383000_45.12.970.22","doi-asserted-by":"publisher","DOI":"10.1007\/BF01068419"},{"key":"2025101112502383000_45.12.970.23","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1213\/ANE.0000000000001922","article-title":"The pathway of injectate spread with the transmuscular quadratus lumborum block: a cadaver study","volume":"125","author":"Dam","year":"2017","journal-title":"Anesth Analg"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2020-101571","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:50:32Z","timestamp":1760212232000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2020-101571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,1]]},"references-count":23,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,11,20]]},"published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1136\/rapm-2020-101571"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2020-101571","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,1]]}}}