Abstract
We report two high risk patients undergoing inguinal herniorraphy and testicular biopsy under ultrasound-guided ilioinguinal/iliohypogastric and genitofemoral nerve blocks. The addition of the genitofemoral nerve block may enhance the ilioinguinal/iliohypogastric block to achieve complete anesthesia and thus avoid general and neuraxial anesthesia related hypotension that may be detrimental in patients with low cardiac reserve.
Highlights
The high incidence of chronic post-surgical pain associated with inguinal hernia repair is well documented [1,2]
We report two high risk patients undergoing inguinal herniorraphy and testicular biopsy under ultrasound-guided ilioinguinal/iliohypogastric and genitofemoral nerve blocks
The addition of the genitofemoral nerve block may enhance the ilioinguinal/iliohypogastric block to achieve complete anesthesia and avoid general and neuraxial anesthesia related hypotension that may be detrimental in patients with low cardiac reserve
Summary
The high incidence of chronic post-surgical pain associated with inguinal hernia repair is well documented [1,2]. The technical difficulty in identifying and selectively blocking the nerves concerned makes the subject to be studied in detail. In particular ilioinguinal/iliohypogastric (II/IH) nerve block has widely been used for inguinal hernia repair. The sensory innervations from genitofemoral (GF) nerve to the inguinal region may provide insufficient analgesia by this technique for intra- and postoperative pain management. An addition of genitofermoral nerve block that improves the quality of analgesia is proposed
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