Inguinal hernioplasty is one of the most commonly performed surgical procedures all over the world. Subarachnoid block is routinely used as an anaesthetic technique of choice without much difficulties and adverse outcomes. However, certain comorbid conditions like ischaemic heart disease, valvular heart disease, coagulopathies, cardiomyopathy etc. increase the risk associated with and limits use of neuraxial blockade as a plan of anaesthesia. Bony deformities like kyphosis and scoliosis make subarachnoid block technically difficult and there is also unpredictable spread of local anaesthetic along subarachnoid space. In such scenarios, general anaesthesia remains the sole technique of choice to undergo planned surgery. This makes the patient bear a wide range of shortcomings like delayed recovery, intensive care unit (ICU) admission, mechanical ventilation, prolonged hospital stay with economic burden along with increased risk of morbidity and mortality.

Inguinal hernia block has wide range of advantages over general anaesthesia in patients with a compromised cardiac status and other co-morbidities. It avoids endotracheal intubation, polypharmacy and subsequent delayed recovery. Further, it decreases the need of ventilator support, provides adequate post-operative analgesia with reduced opioid requirement. The period of hospitalisation is also decreased thus reducing the economic burden. 

Ilioinguinal nerve block (IINB), iliohypogastric nerve block (IHNB) and genital branch of the genitofemoral (GF) nerve blocks completes the anaesthesia and may be used for inguinal hernia repair surgeries.Direct ultrasonographic visualisation of these nerves improves the quality of the block, increases success rate to 95 percent, and reduces the risk for complications.

With this background, the present study will be conducted to evaluate the effectiveness of dexmedetomidine used as an adjuvant with ropivacaine 0.5 percent for ultrasound-guided ilioinguinal, iliohypogastric and genital branch of genitofemoral nerve block as a sole anaesthetic technique in patients undergoing inguinal hernia repair.