FAQs on Ilioinguinal/Genitofemoral Nerve Block

 

The ilioinguinal and genitofemoral nerve blocks are used to alleviate pain in the lower abdomen and pelvic region. These nerve blocks involve injection of an anesthetic, steroidal agent, and/or neurolytic substance onto the targeted nerves.

What are the ilioinguinal and genitofemoral nerves?

The iliohypogastric (IH), ilioinguinal (IL), and genitofemoral (GF) nerves arise from the first lumbar nerve on each side of the body. The IL nerve is smaller than the IH nerve, and both run together as a pair. Along with the GF nerves, these nerves are at risk for being injured during lower abdominal surgery. These surgeries include appendectomy, inguinal herniorrhaphy, C-section, Pfannenstiel incision, and laparoscopic surgery.

What conditions are treated using the ilioinguinal or genitofemoral nerve blocks?

Conditions treated with these blocks include:

  • Post-surgical neuropathy and groin pain
  • Scrotal/testicle pain
  • Labia majora pain
  • Medial thigh pain
  • Chronic hip, groin, and/or pelvic pain

How does the ilioinguinal/genitofemoral nerve block work?

The nerves are in close proximity, so both blocks are usually performed at the same time. The doctor uses some type of live x-ray (fluoroscopy or ultrasound) to guide the procedure needle and ensure accuracy. After you are positioned on your back, the abdomen and thigh are cleaned with an antiseptic. The physician guides the procedure needle near the targeted nerve. A local anesthetic, or other substance, is administered near the nerve. After the needle is removed, a bandage is applied to the insertion site.

How do I prepare for the GF or IL nerve block procedure?

Before you are scheduled for a nerve block, you first meet with the pain management specialist for an evaluation. The doctor will assess your condition, ask questions about your pain levels, and take some additional imaging scans. Once you agree to the block, the doctor will conduct a physical examination and inquire about your current medications. Because bleeding is a risk, you must hold all agents that thin the blood for a few days before your procedure. Arrange to be off from work for a few days, and have someone who can drive you home from the medical center.

Does the ilioinguinal nerve block work?

In a study evaluating outcomes for the ilioinguinal and iliohypogastric nerve blocks, 43 patients were assessed using standardized pain questionnaires. In the study, 88% of patients reported no neuropathic pain or significant reduction in pain. Researchers found these blocks to be effective for treating chronic inguinal pain following groin surgery.

What medications are used during the block?

Depending on your surgeon’s choice, and your personal condition, medications used include:

  • Antimicrobial cleanser – Includes Betadine, alcohol, and other agents.
  • Anesthetic – Bupivacaine or lidocaine.
  • Corticosteroid agent – Triamcinolone, methyl-prednisolone, or dexamethasone.
  • Neurolytic agent – Phenol or absolute alcohol.
  • Sedative – Versed or Valium.

How will I feel after the IL or GF nerve block procedure?

You will be monitored in the recovery room for around 60 minutes after your nerve block procedure. Because a sedative is given, you may feel dizzy, drowsy, or have a dry mouth. Expect some mild soreness at the needle insertion site. Your lower abdomen and pelvic region may feel odd, warm, or different. This is a side effect, which goes away in a few hours.

Resources

Thomassen I, van Suijlekom, JA, van de Gaag A, et al. (2013). Ultrasound-guided ilioinguinal/iliohypogastric nerve blocks for chronic pain after inguinal hernia repair. Hernia, 17(3), 329-332.