95 - Ilioinguinal Nerve Block

Abstract

Ilioinguinal nerve block is useful in the evaluation and management of groin pain thought to be mediated by the ilioinguinal nerve, including the pain associated with ilioinguinal neuralgia. The technique also is useful to provide surgical anesthesia for groin surgery, including inguinal herniorrhaphy, when combined with iliohypogastric and genitofemoral nerve block. Ilioinguinal nerve block with local anesthetic can be used diagnostically during differential neural blockade on an anatomic basis in the evaluation of groin pain to aid in differentiating peripheral nerve entrapment from lumbar radiculopathy. If destruction of the ilioinguinal nerve is being considered, this technique can be used in a prognostic manner to indicate the degree of motor and sensory impairment that the patient may experience. Ilioinguinal nerve block with local anesthetic may be used for palliation in acute pain emergencies, including postoperative pain, during the wait for pharmacologic therapies to take effect. Ilioinguinal nerve block with local anesthetic and steroids also is useful in the treatment of persistent pain after inguinal surgery or groin trauma when the pain is thought to be secondary to inflammation or entrapment of the ilioinguinal nerve. Destruction of the ilioinguinal nerve occasionally is indicated for the palliation of persistent groin pain after blunt or open trauma to the groin or persistent pain mediated by the ilioinguinal nerve after groin surgery. Ilioinguinal nerve block using a 25-gauge needle may be performed in the presence of coagulopathy or anticoagulant therapy, albeit with an increased risk of ecchymosis and hematoma formation.