How is a field block administered for an open inguinal hernia repair?

Updated: Jan 17, 2018
  • Author: Vinay Kumar Kapoor, MBBS, MS, FRCS, FAMS; Chief Editor: Kurt E Roberts, MD  more...
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Answer

A field block is applied by injecting along the site of incision, from superficial to deep, and lateral to the pubic tubercle, to provide anesthesia to the deeper structures. (See Local Anesthetic Agents, Infiltrative Administration.) To block the ilioinguinal nerve, an injection is placed just medial to the anterior superior iliac spine. [50]

Additional amounts of the local agent may be injected throughout the procedure. For example, administration of the agent below the fibers of the external oblique aponeurosis, as described by Lichtenstein’s group, anesthetized the three major nerves by flooding the enclosed inguinal canal and served to hydrodissect the underlying ilioinguinal nerve (thus making it less prone to injury when the aponeurosis was incised). [51]


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