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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Use of genitofemoral and ilioinguinal and iliohypogastric nerve block during orc...
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Vol. 65. Issue 8.
Pages 465-468 (October 2018)
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Vol. 65. Issue 8.
Pages 465-468 (October 2018)
Case report
Use of genitofemoral and ilioinguinal and iliohypogastric nerve block during orchiectomy in a post-lung transplant patient. A case report
Uso de bloqueo genitofemoral en combinación con bloqueo ilioinguinal e iliohipogástrico para orquiectomía en paciente postrasplantado pulmonar. A propósito de un caso
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B.A. Rivas Rivero
Corresponding author
berthaixar@gmail.com

Corresponding author.
, A. Mira Puerto, J. Cuenca
Servicio de Anestesiología, Hospital Universitario Sant Joan de Reus, Reus, Spain
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Abstract

The case is presented of a post-lung transplant patient, ASA III, proposed for orchiectomy due to testicular cancer. A combination of iliohypogastric (ILH), ilioinguinal (ILI) and genitofemoral (GF) nerve block together with sedation was used as anaesthetic technique.

The inguinal area received sensory innervation mainly from ILI, ILH and GF nerves. The genital branch of the GF nerve supplies innervation to skin of the anterosuperior portion of the scrotum.

When performing the echo-guided block of GF nerve, it is necessary to identify the spermatic cord, and administer the local anaesthetic on the inside and periphery of the cord.

Peripheral nerve blocks are a valid option for complex patients. Its main advantage is the anaesthesia and analgesia level that it provides without the haemodynamic instability associated with general or neuraxial anaesthesia. GF nerve block provides hemi-scrotal anaesthesia, allowing manipulation and intervention in the inguinal-scrotal area, complementing the anaesthesia provided by ILI and ILH nerve blocks.

Keywords:
Lung transplant
Genitofemoral block
Ilioinguinal block
Iliohypogastric block
Testicular surgery
Resumen

Presentamos el caso de un paciente postrasplantado pulmonar, ASA III, propuesto para orquiectomía por neoplasia testicular. La técnica anestésica era la combinación de bloqueo iliohipogástrico (ILH), ilioinguinal (ILI) y genitofemoral (GF) con sedación.

El área inguinal recibe inervación sensitiva principalmente de los nervios ILI, ILH y GF, la rama genital de este último inerva piel de la porción anterosuperior del escroto.

Al realizar el bloqueo ecoguiado del nervio GF, es necesario identificar el cordón espermático y administrar anestésico local por dentro y por fuera para cubrir variaciones anatómicas del nervio.

Los bloqueos periféricos son una opción factible para pacientes complejos. Su principal ventaja es la anestesia y analgesia del área sin la inestabilidad hemodinámica asociada a la anestesia general y neuroaxial. El bloqueo del nervio GF aporta anestesia hemiescrotal, lo que permite la manipulación e intervención sobre esta área, complementando la anestesia aportada por el bloqueo de los nervios ILI e ILH.

Palabras clave:
Trasplante pulmonar
Bloqueo genitofemoral
Bloqueo ilioinguinal
Bloqueo iliohipogástrico
Cirugía testicular

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