Anesthetic management by psoas compartment block for adult inguinal herniorrhaphy

Spinal anesthesia has been often used for inguinal herniorrhaphy. With the advancement of surgical technique, tension free inguinal herniorrhaphy is now performed under local anesthesia. Local anesthesia, however, does not always offer sufficient anesthesia. We performed psoas compartment block with 1% lidocaine in a 78-year-old man undergoing tension free inguinal herniorrhaphy. During the operation, the patient felt pain and needed additional local anesthesia once. But the pain was not severe, and he did not feel stressed. Advantages of psoas compartment block for inguinal herniorrhaphy are its easiness to perform, little burden of anesthesia and high efficacy. Demerits are slow onset of block and necessity for prolonged patient monitoring. Further investigations on dose and patient position are required for psoas compartment block to become useful for inguinal herniorrhaphy.