Ilioinguinal Nerve Block

Indications

Postoperative Lower abdominal/Groin Pain
Post Cesarean Section Pain
Post Inguinal Hernia Repair
Somatic pain
Neuralgia
Postoperative lower abdominal/groin pain (acute and chronic), post c-section pain, post inguinal hernia repair, somatic abdominal pain

Ultrasound Technique

Draw line from ASIS to Umbilicus
Place Probe on line
Angle probe towards the posterior lateral direction
Doppler for Vasculature as Nerve is in this plane
Perforate Internal and External Oblique

Injectate

4-7ml of Bupivicaine 0.25% or Ropivicaine 0.5%
Consider Depomedrol or Dexamethasone if Chronic Pain or Inflammatory Component
Injecting higher volumes may predispose to a femoral nerve block

Complications

Vascular injection
Nerve injury
Bowel perforation
Hematoma
Femoral nerve block

References

Kulacoglu H, Ergul Z, Esmer AF, Sen T, Akkaya T, Elhan A. Percutaneous ilioinguinal-iliohypogastric nerve block or step-by-step local infiltration anesthesia for inguinal hernia repair: what cadaveric dissection says? J Korean Surg Soc. 2011 Dec;81(6):408-13. doi: 10.4174/jkss.2011.81.6.408. Epub 2011 Nov 25. PMID: 22200042; PMCID: PMC3243858.
Waldman SD (2015) Chapter 86 – Ilioinguinal Nerve Block. In: Atlas of Interventional Pain Management (4thedn), W.B. Saunders, Philadelphia, 431-434.
Mirjalili SA (2015) Chapter 45 - Anatomy of the Lumbar Plexus. In: Nerves and Nerve Injuries, edited by Tubbs RS, Rizk E, Shoja M, Loukas M, Barbaro N, et al. (Eds.), Academic Press, San Diego, 609-617.
Eichenberger U, Greher M, Kirchmair L, Curatolo M, Moriggl B (2006) Ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerve: accuracy of a selective new technique confirmed by anatomical dissection. Br J Anaesth 97: 238-243.

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