Ilioinguinal block: Complications
- Local anesthetic toxicity – this is a risk, but it is very low given the small amount of local needed to perform these blocks
- Hemodynamic changes – highly unlikely given the fact that the block is limited to the lower abdominal wall and inguinal region
- Injury to the anesthetized area – as with any other block the patient must be counseled to avoid trauma to areas that are numb
- Later femoral cutaneous or femoral nerve blockade – some of the local anesthetic could track down below the inguinal ligament along the fascia iliaca, giving rise to an unintended block of the femoral nerve. If this occurs the surgical team should be made aware and the patient should be counseled regarding protection of the anesthetized area and the potential for falls.
- Small and/or large bowel perforation – given the close proximity in extremely thin patients and the potential loss of layers or deconditioning of layers of the abdominal wall in older/deconditioned patients, perforation of the bowel is a risk with this block. Blunt tipped needles (compared to sharp needles) help the operator to feel the various fascial layers of the abdominal wall. Care must also be observed in patients with little abdominal wall musculature, because the normal three distinct layers may be too thin to appreciate a loss of resistance between