For the ilioinguinal nerve block, with the patient in supine position,
palpate the most medial part of the ASIS. Mark a point 1 cm medial and
1 cm caudal to the most medial part of the ASIS.
insertion is 1 cm medial and 1 cm cephalad to the most medial part of
the ASIS (Fig. 72-1).
(Purdue Pharma L.P., Stamford, CT). Next, a 50-mm insulated needle
attached to a 10-mL syringe and a nerve stimulator is introduced
through the skin. The nerve stimulator is set up to deliver 1.5 mA. The
needle is advanced with continuous aspiration in an oblique angle
toward the pubic symphysis. Once paresthesia is elicited, the needle
position is adjusted to maintain the paresthesia with a current of 0.4
mA. After negative aspiration for blood, the local anesthetic mixture
is slowly injected. The needle is then removed, and pressure is applied
to reduce the risk of postblock ecchymosis and hematoma.
Figure 72-1. Point of needle insertion.