Ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerve: accuracy of a selective new technique confirmed by anatomical dissection

Eichenberger, Urs; Greher, Manfred; Kirchmair, Lukas; Curatolo, Michele; Moriggl, Bernhard

doi:10.1093/bja/ael103

Cited by 191 publications

(83 citation statements)

References 15 publications

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“…The study was performed according to the ethical guidelines of the Swiss Academy of Medical Sciences for investigations using human cadavers [21]. The cadavers were embalmed using Thiel's method [22], which renders cadaveric tissue similar in texture to that of live humans, enabling sonographic studies to be performed [18,23,24].…”

Section: Methodsmentioning

confidence: 99%

Placement of coiled catheters into the paravertebral space*

et al. 2012

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SummaryThere are conflicting results with regard to the use of catheter-based techniques for continuous paravertebral block. Local anaesthetic spread within the paravertebral space is limited and the clinical effect is often variable. Discrepancies between needle tip position and final catheter position can also be problematic. The aim of this proof-of-concept study was to assess the reliability of placing a newly developed coiled catheter in human cadavers. Sixty Tuohy needles and coiled catheters were placed under ultrasound guidance, three on each side of the thoracic vertebral column in 10 human cadavers. Computed tomography was used to assess needle tip and catheter tip locations. No catheter was misplaced into the epidural, pleural or prevertebral spaces. The mean (SD) distance between catheter tips and needle tips was 8.2 (4.9) mm. The median (IQR [range]) caudo-cephalad spread of contrast dye injectate through a subset of 20 catheters was 4 (4-5[3-8]) thoracic segments. All catheters were removed without incident. Precise paravertebral catheter placement can be achieved using ultrasound-guided placement of a coiled catheter.

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Section: Methodsmentioning

confidence: 99%

Placement of coiled catheters into the paravertebral space*

et al. 2012

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“…If using the blind, AL technique, they suggested a new injection point 5 cm cranial and 5 cm posterior to the ASIS may be advantageous and reduce failure rates. In this area, the median distance of the IL nerve to the iliac bone was 6.0 mm, and the distance the two nerves was 10.4 mm [27].…”

Section: Discussionmentioning

confidence: 85%

Untitled

2017

Cent Asian J Med Sci

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Objectives:To examine ilioinguinal and iliohypogastric (ILIH) nerve block techniques among children. Methods: A total of 120 children, aged 1-16 years, were included in this prospective, randomized, single-blinded study. Children received an ILIH nerve block using the conventional fascial click of double "pop" technique on four different points: (Group I, n=30) ILIH block at the junction of the lateral one-fourth, the medial three-fourth in the line from the anterior superior iliac spine (ASIS) to the umbilicus; (Group II, n=28) approximately 2.5 mm medial to the ASIS; (Group III, n=30) 10 mm medial-superior to the ASIS; and (Group IV, n=30) 10mm medial-inferior to the ASIS. Intraoperative hemodynamic changes, postoperative pain intensity, time of first analgesic requirement, and correlation between BMI and groups were examined. Results: The average pain score 2 hours after operation was lowest in group I (1.04±1.23 [Cl 95%,) and highest in group IV (2.88±2.47 [Cl 95%, 0-9]), a difference of statistically significance (p=0.0027). In group I only, the pain intensity had a weak, positive correlation with BMI (r=0.49, p=0.006). Conclusion: Group I used the best ILIH block technique.

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“…Another reported complication by M. John and R Sossai 12 is colonic puncture which can be prevented by using a short bevel needle. Another reported complication is pelvic hematoma 13. In an ideal set up, ilioinguinal nerve block should be done under ultrasound guidance 14,15 but lack of availability in our institution prevented us from using it.…”

Section: Statistical Analysis and Resultsmentioning

confidence: 99%