Response to Dr. Baumgarten's comments.

To the Editor: In response to Dr. Richard K. Baumgarten's letter, we would like to emphasize the following:

First, our study is a retrospective one on 126 patients who had undergone inguinal hernia repair.

Second, in our hospital, all patients sign a consent form which gives us permission to use their medical records in future scientific studies.

Third, several anesthetic techniques can be used for inguinal herniorrhaphy. The goal of our study was to compare spinal anesthesia (SA) with ilioinguinal-iliohypogastric nerve block (IHNB).

Fourth, we reviewed the charts of patients who had undergone surgery between 1999 and 2002. That was before the publication of articles by Willschke et al (1) and Eichenberger et al (2) on ultrasound-guided ilioinguinal-iliohypogastric nerve block. Hence, we were not able to evaluate their technique in our study. I agree with the authors who point out that paravertebral block (PVB) is an ideal alternative technique that can be used in inguinal herniorrhaphy. (3)

We appreciate Dr. Baumgarten's interest in our article.

Aysun Yilmazlar, MD

From the Department of Anesthesiology

Uludag University Medical School Bursa, Turkey

References

1. Willschke H, Marhofer P, Bosenberg A, et al. Ultrasonography for ilioinguinal/iliohypogastric nerve blocks in children., Br J Anaesth 2005;95:226-230.

2. Eichenberger U, Greher M, Kirchmair L, et al. Ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerve: accuracy of a selective new technique confirmed by anatomical dissection. Br J Anaesth 2006;97:238-243.

3. Ganapathy S. Paravertebral blocks for chest, truncal, and abdominal procedures. In: Steele SM, Nielsen KC, Klein SM, editors. Ambulatory Anesthesia Perioperative Analgesia. 1st edition. McGraw-Hill Inc, 2005, p 329.