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Background and Aims Lumbar erector spinae plane block (L-ESPB) and transversus abdominis plane block (TAPB) have been applied in inguinal hernia postoperative pain control. Regarding surgical anesthesia for open inguinal hernia repair (OIHR), there have been case reports of the application of either L-ESPB or TAPB alone, and one randomized controlled trial comparing the use of spinal anesthesia and L-ESPB combined with local infiltration anesthesia. To our knowledge, there is no literature on the use of L-ESPB combined with TAPB as surgical anesthesia for OIHR. We report ten successful cases of OIHR performed under L-ESPB combined with TAPB.Methods Ten patients (nine males) admitted for elective inguinal hernia repair consented to receive an L-ESPB and TAPB after hearing their options. Our patients’ ages ranged between 40 and 77 years, and their BMI between 20.5 and 30.1. Upon entrance to the OR, our patients were premedicated, depending on their age, with either 2 mg of bolus midazolam or a 10-minute infusion of 1 μg/kg dexmedetomidine. An L- ESPB at the second lumbar vertebral level with 30 mL of 0.5% ropivacaine and 5 μg/mL of adrenaline was then performed, followed by a TAPB with 20 mL of 0.375% ropivacaine and 5 μg/mL adrenaline, both under ultrasound guidance. A continuous infusion of 0.6 μg/kg/hr dexmedetomidine was initiated before incision.Results Our patients remained conscious, calm and cooperative throughout surgery, which lasted an average of 70 minutes (45 to 120 minutes). Adequate post-operative pain control was achieved with 1 g of paracetamol every six hours and 50 mg of dexketoprofen every 12 hours. Our patients were mobilized three hours after surgery and discharged the following day.Conclusions The combination of L-ESPB and TAPB was safe and effective in providing surgical anesthesia for our patients‘ OIHR. Our cases warrant further investigation of this novel anesthetic modality of combined L-ESPB/TAPB for OIHR.