Post Operative Pain Control
You have decided to your inguinal hernia or your sports hernia repaired, but you are worried about having pain after surgery. Luckily by understanding the innervation of the region, pain control after surgery has vastly improved. The ilioinguinal and the iliohypogastric nerves provide sensation to the inguinal region. These nerves start at L1 and L2 and then travel to the inguinal region between oblique muscles. Local anesthetics can be used to block the nerves and thereby minimize postoperative pain.
Types of Nerve Blocks
- TAP Block (transversus abdominis plane). Using an ultrasound machine the ilioinguinal and the iliohypogastric nerves are visualized between the transversalis muscle and the internal oblique muscle. Then a needle is used to inject local anesthetic around the nerves.
- The ilioinguinal and an iliohypogastric nerves can also be blocked at the anterior superior iliac spine. At this site the nerves travel between oblique muscles. The type of block does not require the use of ultrasound.
- Regional Block involves injecting the local anesthetic directly into the operative site.
The TAP block is the best method to control pain after surgery. The block lasts for about 16 hours, but can last up to 48 hours. But the block requires a good ultrasound machine and practice.
The nerve block at the anterior superior iliac spine is also very effective. It does not last as long as the TAP block, but can be easily done when an ultrasound machine is not available.
The Regional Block does not last as long as the other two blocks, but it is often combined with one of the other blocks.
If you think you may be suffering from a sports hernia, please consider making an appointment with Dr. Brown to see if you’re right. Dr. Brown specializes in working with hernia patients, and is an expert at the process of diagnosis, treatment, and recovery.