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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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Chapter 36 – Inguinal Block

PERSPECTIVE

Inguinal block is primarily a peripheral block technique for inguinal herniorrhaphy.

Patient Selection.

Increasing numbers of patients are undergoing inguinal herniorrhaphy as outpatients; thus, this block may be incorporated into most practices.

Pharmacologic Choice.

As with many of the peripheral regional blocks, motor blockade is not essential for success with inguinal block. Therefore lower concentrations of intermediate- to long-acting local anesthetics can be chosen. For example, 1% lidocaine or 1% mepivacaine is appropriate, as is 0.25% bupivacaine or 0.2% ropivacaine. The anesthesiologist should be aware that it is often necessary to supplement the inguinal block intraoperatively by the surgeon injecting the vicinity of the spermatic cord. Therefore, the volume of local anesthetic used during the initial block should not preclude additional intraoperative injection.

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