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CHAPTER 35 – Inguinal field block

Jack Barrett,
Dominic Harmon

The inguinal region includes the inguinal canal, spermatic cord, surrounding skin and subcutaneous tissue. It receives sensory innervation from the 11th and 12th thoracic nerves and the ventral divisions of the first and second lumbar spinal nerves. The cutaneous branches of the lumbar plexus include the iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous nerves, and the obturator nerves. Local anesthesia is used frequently for inguinal hernia repair. This surgery is more commonly being performed as an ambulatory procedure, and regional anesthesia may offer advantages for this; it may also be the technique of choice in patients with intercurrent diseases. The technique involves the blocking of the ilioinguinal, iliohypogastric, and genitofemoral nerves in combination with subcutaneous injection.

This chapter describes techniques for blocking these nerves, which can also be used individually for postoperative pain …