Local Anesthesia and Nerve Blocks

Abstract

Many inguino-scrotal procedures in urology can be performed under local anesthesia. Sometimes local anesthetics are used to supplement post-operative pain relief in patients who had general anesthesia. The common nerve blocks are an inguinal block for hernia repairs and inguinal orchidectomies, a cord block for vasectomies, and a penile block for circumcision and frenuloplasty. The testis and scrotum are innervated by the ilioinguinal, genitofemoral, pudendal, and posterior scrotal nerves. L1-S3 provide the autonomic nerve supply; T10-L4 provide the sympathetic nervous system; and S1-S3 provide the parasympathetic nerve supply. The penis is supplied by the dorsal nerve and the posterior scrotal branches of the pudendal nerve, as well as the ilioinguinal, genitofemoral, and posterior cutaneous nerve of the thigh.