Ilioinguinal nerve block has shown great utility as a diagnostic, prognostic, and therapeutic maneuver in the evaluation and treatment of groin and genital pain that is thought to be mediated via the ilioinguinal nerve. When combined with iliohypogastric and genitofemoral nerve block, ilioinguinal nerve block can also be utilized to provide surgical anesthesia for groin and genital surgery. While ilioinguinal nerve block can be performed utilizing a anatomic landmark guided technique, the addition of ultrasound guidance will improve the accuracy of needle placement and decrease complications. This article describes a simplified technique for performing ultrasound guided ilioinguinal nerve block.
The patient is placed on the x-ray table on their back and positioned in such a way that the physician can best visualize the landmarks that indicate the area to be injected. The skin in the inguinal area is cleansed using a solution called Betadine. The physician injects an area of skin with numbing medicine. This stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a very small needle, using x-ray guidance into the area of the inguinal nerve. A small mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) is injected. What happens after the procedure?
Immediately after the injection, pressure is applied to the injection site to decrease the incidence of post block bruising or swelling. The patient is transferred to the recovery area for approximately 15 minutes. Patients are asked to report the percentage of pain relief and report the relief experienced during the next week by calling the clinic.
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