Ultrasound guided hernia blocks

Abstract

Inguinal hernia surgery is one of the commonest day case procedure in any surgical unit, and one of
the procedures that has a very high incidence of persistent post-surgical pain. Blocks of the ilioinguinal
and iliohypogastric nerves may reduce the incidence of this chronic pain. Blocking the genital branch of
genitofemoral nerve completes the nerve block for inguinal hernia surgeries. All these three nerves can
be easily blocked under ultrasound guidance and this improves the effectiveness of the block. Failures in
achieving complete anesthesia and analgesia is not always due to technical reasons, anatomical variations
may be the cause in some of the cases. This article describes the anatomy, sonoanatomy, the variations
and the nerve blocks under ultrasound guidance.