Ultrasound guidance for ilioinguinal/iliohypogastric nerve block: a pilot study.

Background: Ilioinguinal/iliohypogastric nerve block combined with general anaesthesia facilitates inguinal herniorrhaphy in an ambulatory setting by improving analgesia and reducing opioid requirements. Case reports in children indicate the possibility of colonic puncture and associated morbidity with blind ilioinguinal and iliohypogastric blockade.

Objective: To investigate the feasibility of ultrasound guided ilioinguinal/iliohypogastric nerve block.

Methods: Pilot study of four patients where ultrasound imaging was used to identify the ASIS, anterior abdominal muscle layers, the peritoneum and to guide local anaesthetic infiltration in patients undergoing inguinal hernia surgery and appendicectomy.

Results: All patients had successful blocks, without complications. Mean visual analogue scores were 2/10 in the post anaesthesia care unit. Mean opioid consumption was 10 mg of intramuscular morphine in the first 24 h.

Conclusions: Ultrasound guidance for ilioinguinal and iliohypogastric nerve block in the inguinal region is both feasible and a promising technique.