Revisiting the anatomy of the ilio‐inguinal/iliohypogastric nerve block

Schoor, Albert-Neels Van; Bosman, Marius C.; Bösenberg, Adrian

doi:10.1111/pan.12099

Cited by 9 publications

(7 citation statements)

References 12 publications

(13 reference statements)

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“…Although this is true in the majority of individuals, there is significant variability, with up to 20% having origins from the L2 and L3 nerve roots. [14][15][16] Both nerves emerge at the lateral border of psoas major and run inferolaterally on the ventral surface of QLM and TAM, just superior and parallel to the iliac crest (Fig. 2).…”

Section: Innervation Of the Anterior Abdominal Wallmentioning

confidence: 99%

“…Unfortunately, the course and location of the II and IH nerves with regard to the ASIS vary significantly with age and between individuals. 14,15,148 Cadaveric investigations in neonates have shown that the commonly used techniques are relatively inaccurate in pinpointing the II-IH nerves 149 and that the nerves lie much closer to the ASIS (3 mm on average; 95% confidence interval, 2.8-3.2 mm) 16 than assumed.…”

Section: Landmark-guided Techniquementioning

confidence: 99%

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Essentials of Our Current Understanding

Chin

McDonnell

Carvalho

et al. 2017

Regional Anesthesia and Pain Medicine

332

208

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Abdominal wall blocks rely on the spread of local anesthetic within musculofascial planes to anesthetize multiple small nerves or plexuses, rather than targeting specific nerve structures. Ultrasonography is primarily responsible for the widespread adoption of techniques including transversus abdominis plane and rectus sheath blocks, as well as the introduction of novel techniques such as quadratus lumborum and transversalis fascia blocks. These blocks are technically straightforward and relatively safe and reduce pain and opioid requirements in many clinical settings. The data supporting these outcomes, however, can be inconsistent because of heterogeneity of study design. The extent of sensory blockade is also somewhat variable, because it depends on the achieved spread of local anesthetic and the anatomical course of the nerves being targeted. The blocks mainly provide somatic analgesia and are best used as part of a multimodal analgesic regimen. This review summarizes the anatomical, sonographic, and technical aspects of the abdominal wall blocks in current use, examining the current evidence for the efficacy and safety of each.

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Section: Innervation Of the Anterior Abdominal Wallmentioning

confidence: 99%

Section: Landmark-guided Techniquementioning

confidence: 99%

Essentials of Our Current Understanding

Chin

McDonnell

Carvalho

et al. 2017

Regional Anesthesia and Pain Medicine

332

208

View full text Add to dashboard Cite

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“…Under sterile conditions, a needle can be introduced under ultrasound guidance in a medial to lateral direction, i.e., toward the iliac muscle and bone. In the absence of an ultrasound guide, the needle insertion distance (mm) is 0.6 × weight (kg) + 1.8 [ 209 ]. The muscle layers in neonates are thin and compliant.…”

Section: Peripheral Nerve Blocksmentioning

confidence: 99%

Regional Anesthesia

Bösenberg¹

2014

Neonatal Anesthesia

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“…Due to these differences, complication rates following injuries to various anatomical structures may increase in pediatric patients if adult landmarks are only duplicated in children (Marhofer, ). One study, investigating the anatomy of peripheral nerves of the trunk using neonate and infant cadavers, has also identified the inappropriateness of “downscaling” the anatomical findings from adult studies for use in infants and children (Van Schoor et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…Also despite the many procedural advantages of the ultrasound‐guided techniques, the clinical benefits on analgesic outcome may still be small (Suresh et al, ). Based on this experience, it is true to say that peripheral nerve blockades are best performed by utilizing simple, direct, and reliable surface landmarks (Johnson, ), and sound comprehensive knowledge of regional anatomy is vital for successful nerve blockades even when using ultrasound (Tsui and Suresh, , Van Schoor et al, ).…”

Section: Introductionmentioning

confidence: 99%

Pediatric regional anesthesia: A review of the relevance of surface anatomy and landmarks used for peripheral nerve blockades in infants and children

Byun

Pather

2019

Clinical Anatomy

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In regional anesthesia, accurate knowledge of surface anatomy and landmarks are essential for successful nerve blockades with least possible complications. The longestablished anatomical landmarks used for peripheral nerve blockades in adult patients have also gained a place in pediatric anesthesia. Despite the continuing benefits and need for more effective peripheral techniques in pediatrics, there is a paucity of data on pediatric landmarks, and hence the absence of more appropriate techniques for the different age groups of children. Recent advancement in imaging has shown that there is a greater awareness for the different surface projections at various stages of postnatal development, as compared with that of adults. Thus, if adult landmarks are not appropriately adapted for use in children, complication rates may rise due to injuries to anatomical structures. This review evaluated the existing evidence of the pediatric nerve block landmarks in the reported literature, in order to highlight the limitations in our current understanding of pediatric surface anatomy and landmarks. A literature search was done using five databases to obtain 141 references. Only a few of these studies provided detailed reports of the relations of relevant nerves to anatomical landmarks. A few clinical imaging studies have provided new anatomical landmarks in children with reference to their age-related growth and anatomy. Most landmarks need to be standardized in children of various ages, and furthermore, inconsistencies in the current descriptions of the surface landmarks need to be validated and standardized for use in pediatric clinical practice. Clin. Anat. 32:803-823, 2019.

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Revisiting the anatomy of the ilio‐inguinal/iliohypogastric nerve block

Abstract: Background: The ilio-inguinal / iliohypogastric nerve block (INB) is one of the most common peripheral

Cited by 9 publications

References 12 publications

Essentials of Our Current Understanding

Essentials of Our Current Understanding

Regional Anesthesia

Pediatric regional anesthesia: A review of the relevance of surface anatomy and landmarks used for peripheral nerve blockades in infants and children

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