Anatomical bases of prolonged ilio-inguinal-hypogastric regional anesthesia

Peschaud, Frédérique; Malafosse, Robert; Floch-Prigent, Patrice Le; Coste-See, Carole; Nordlinger, Bernard; Delmas, V.

doi:10.1007/s00276-006-0132-x

Cited by 7 publications

(6 citation statements)

References 17 publications

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“… 157 – 170 Anesthesiology-based studies have been done to improve nerve block success. 157 – 159 Surgical anatomical studies have been done in the hopes of preventing nerve injury during different approaches in this area. 157 , 160 – 168 These anesthesiology-based and surgical anatomical studies report data on retroperitoneal and/or anterior nerve distribution patterns.…”

Section: Pain: Prevention and Treatmentmentioning

confidence: 99%

“…Pooled results of anatomical studies indicate that the IHN was present in 864 of 879 inguinal dissections (98%, range 60–100%). 157 , 159 – 166 , 168 The IIN was present in 1217 of 1443 dissections (84%, range 56–100%). 157 – 169 The genital branch (GB) of the GFN was present in 256 of 258 dissections (99%) 160 , 165 , 166 , 170 .…”

Section: Pain: Prevention and Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,557

712

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IntroductionWorldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery.MethodsAn expert group of international surgeons (the HerniaSurge Group) and one anesthesiologist pain expert was formed. The group consisted of members from all continents with specific experience in hernia-related research. Care was taken to include surgeons who perform different types of repair and had preferably performed research on groin hernia surgery. During the Group’s first meeting, evidence-based medicine (EBM) training occurred and 166 key questions (KQ) were formulated. EBM rules were followed in complete literature searches (including a complete search by The Dutch Cochrane database) to January 1, 2015 and to July 1, 2015 for level 1 publications. The articles were scored by teams of two or three according to Oxford, SIGN and Grade methodologies. During five 2-day meetings, results were discussed with the working group members leading to 136 statements and 88 recommendations. Recommendations were graded as “strong” (recommendations) or “weak” (suggestions) and by consensus in some cases upgraded. In the Results and summary section below, the term “should” refers to a recommendation. The AGREE II instrument was used to validate the guidelines. An external review was performed by three international experts. They recommended the guidelines with high scores.Results and summaryThe risk factors for inguinal hernia (IH) include: family history, previous contra-lateral hernia, male gender, age, abnormal collagen metabolism, prostatectomy, and low body mass index. Peri-operative risk factors for recurrence include poor surgical techniques, low surgical volumes, surgical inexperience and local anesthesia. These should be considered when treating IH patients. IH diagnosis can be confirmed by physical examination alone in the vast majority of patients with appropriate signs and symptoms. Rarely, ultrasound is necessary. Less commonly still, a dynamic MRI or CT scan or herniography may be needed. The EHS classification system is suggested to stratify IH patients for tailored treatment, research and audit. Symptomatic groin hernias should be treated surgically. Asymptomatic or minimally symptomatic male IH patients may be managed with “watchful waiting” since their risk of hernia-related emergencies is low. The majority of these individuals will eventually require surgery; therefore, surgical risks and the watchful waiting strategy should be discussed with patients. Surgical treatment s...

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Section: Pain: Prevention and Treatmentmentioning

confidence: 99%

Section: Pain: Prevention and Treatmentmentioning

confidence: 99%

International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,557

712

View full text Add to dashboard Cite

show abstract

“…Looking at the literature, only two anatomical studies have investigated the presence and course of the three inguinal nerves together [55,64], while others have investigated the presence and course of only one or two inguinal nerves [8,9,19,27,39,42,47,50,51,53,62].…”

Section: Is It Possible To See All Three Nerves?mentioning

confidence: 99%

International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery

Alfieri

Amid

Campanelli

et al. 2011

Hernia

363

234

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Purpose To provide uniform terminology and definition of post-herniorrhaphy groin chronic pain. To give guidelines to the scientific community concerning the prevention and the treatment of chronic groin and testicular pain. Methods A group of nine experts in hernia surgery was created in 2007. The group set up six clinical questions and continued to work on the answers, according to evidencebased literature. In 2008, an International Consensus Conference was held in Rome with the working group, with an audience of 200 participants, with a view to reaching a consensus for each question.

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“…In the lateral inter-muscular space, the iliohypogastric nerve follows a common course with the ilioinguinal nerve over 5.6-9.0 cm (mean: 7.2 ± 3 cm). This course was always 2 cm below the anterior superior iliac spine [ 30 ]. Table 5 shows the reported mean distances from the emergence of the iliohypogastric nerve in the internal oblique muscle to the anterior superior iliac spine.…”

Section: Reviewmentioning

confidence: 99%

Anatomical Variations of the Iliohypogastric Nerve: A Systematic Review of the Literature

Manolakos¹,

Zygogiannis²,

Mousa³

et al. 2022

Cureus

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Several anatomical variations of the iliohypogastric nerve branches have been observed in earlier studies. Knowledge of these variations is useful for the improvement of peripheral nerve blocks and avoidance of iatrogenic nerve injuries during surgeries. The purpose of this study was to perform a systematic review of the literature about the anatomical topography and variations of the iliohypogastric nerve. An extensive search on PubMed, Scopus, and Web of Science electronic databases was conducted by the first author in November 2021, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Anatomical or cadaveric studies about the origin, the course, and the distribution of the iliohypogastric nerve were included in this review. Thirty cadaveric studies were included for qualitative analysis. Several anatomical variations of the iliohypogastric nerve were depicted including its general properties, its origin, its branching patterns, its course, its relation to anatomical landmarks, and its termination. Among them, the absence of the iliohypogastric nerve ranged from 0 to 34%, its origin from L1 ranged from 62.5 to 96.5%, and its isolated emergence from psoas major ranged from 47 to 94.5%. Numerous anatomical variations of the iliohypogastric nerve exist but are not commonly cited in classic anatomical textbooks. The branches of the iliohypogastric nerve may be damaged during spinal anesthesia and surgical procedures in the lower abdominal region. Therefore, a better understanding of the regional anatomy and its variations is of vital importance for the prevention of iliohypogastric nerve injuries.

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Anatomical bases of prolonged ilio-inguinal-hypogastric regional anesthesia

Cited by 7 publications

References 17 publications

International guidelines for groin hernia management

International guidelines for groin hernia management

International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery

Anatomical Variations of the Iliohypogastric Nerve: A Systematic Review of the Literature

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