97 - Genitofemoral Nerve Block

Abstract

Genitofemoral nerve block is useful in the evaluation and management of groin pain thought to be mediated by the genitofemoral nerve, including the pain associated with genitofemoral neuralgia. The technique also is useful to provide surgical anesthesia for groin surgery, including inguinal herniorrhaphy, when combined with iliohypogastric and ilioinguinal nerve block. Recently, genitofemoral nerve block has been combined with femoral nerve block to provide anesthesia for endovascular aortic aneurysm repair. Genitofemoral nerve block with local anesthetics 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 genitofemoral 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. Genitofemoral nerve block with local anesthetic may be used for palliation in acute pain emergencies, including postoperative pain, during the wait for pharmacologic therapies to become effective. Genitofemoral 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 genitofemoral nerve. Destruction of the genitofemoral nerve is occasionally indicated for the palliation of persistent groin pain after blunt or open trauma to the groin or persistent pain mediated by the genitofemoral nerve after groin surgery. Genitofemoral 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.