Korean J Pain.  2016 Jul;29(3):193-196. 10.3344/kjp.2016.29.3.193.

Continuous Ilioinguinal-iliohypogastric Nerve Block for Groin Pain in a Breast-feeding Patient after Cesarean Delivery

Affiliations
  • 1Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea. hakykim@pusan.ac.kr

Abstract

Ilioinguinal and iliohypogastric (II/IH) nerve injury is one of the most common nerve injuries following pelvic surgery, especially with the Pfannenstiel incision. We present a case of intractable groin pain, successfully treated with a continuous II/IH nerve block. A 33-year-old woman, following emergency cesarean section due to cephalopelvic disproportion, presented numbness in left inguinal area and severe pain on the labia on the second postoperative day. The pain was burning, lancinating, and exacerbated by standing or movement. However, she didn't want to take additional medicine because of breast-feeding. A diagnostic II/IH nerve block produced a substantial decrease in pain. She underwent a continuous II/IH nerve block with a complete resolution of pain within 3 days. A continuous II/IH nerve block might be a goodoption for II/IH neuropathy with intractable groin pain in breast-feeding mothers without adverse drug reactions in their infants.

Keyword

Adverse drug reactions; Breast-feeding; Groin; Iliohypogastric; Ilioinguinal; Pfannenstiel incision

MeSH Terms

Adult
Burns
Cephalopelvic Disproportion
Cesarean Section
Drug-Related Side Effects and Adverse Reactions
Emergencies
Female
Groin*
Humans
Hypesthesia
Infant
Mothers
Nerve Block*
Pregnancy

Figure

  • Fig. 1 (A) An ultrasound image shows a needle between internal oblique muscle (IOM) and transversus abdominis muscle (TAM) (B) A catheter is inserted into the local anesthetic pocket between two muscle layers.


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