A 60-year-old man is scheduled for an open inguinal hernia repair. The anaesthesiologist plans a peripheral nerve block targeting the ilioinguinal and iliohypogastric nerves. At which anatomical location are these nerves typically targeted for the block?
- A Just medial to the anterior superior iliac spine (ASIS), between the internal oblique and transversus abdominis muscles ✓
- B Between the internal oblique and transversus abdominis muscles, at the midpoint of the inguinal ligament
- C Within the psoas major muscle
- D Within the transversalis fascia
Correct answer: A. Just medial to the anterior superior iliac spine (ASIS), between the internal oblique and transversus abdominis muscles
Explanation
The ilioinguinal and iliohypogastric nerves (L1) travel between the internal oblique and transversus abdominis muscles. For the block, the needle is directed just medial and superior to the anterior superior iliac spine (ASIS), targeting this fascial plane. Option B describes the TAP block location, while C and D are incorrect anatomical landmarks for these specific nerves.
Reference: Miller's Anesthesia, 9th ed.
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Written and medically reviewed by the StethoPrep medical team.