Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves
CPT4 code
Name of the Procedure:
Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves
Summary
This procedure involves injecting anesthetic agents and/or steroids into the ilioinguinal and iliohypogastric nerves to alleviate pain. It is minimally invasive and typically used to manage chronic pain or inflammation.
Purpose
Medical Condition: Chronic pain in the lower abdomen or groin area due to nerve irritation. Goals: To provide pain relief and reduce inflammation by delivering medication directly to the affected nerves.
Indications
- Chronic lower abdominal or groin pain.
- Pain following surgical procedures in the lower abdomen such as hernia repairs.
- Diagnostic tool to confirm pain origin.
Patient Criteria: Patients experiencing significant pain that has not responded to other conservative treatments.
Preparation
- Patients may need to fast for a few hours before the procedure.
- Medication adjustments might be required, particularly if taking blood thinners.
- Diagnostic imaging, such as an ultrasound or MRI, may be needed to plan the injection.
Procedure Description
- Patient Positioning: The patient lies on their back.
- Skin Preparation: The injection site is cleaned and sanitized.
- Local Anesthesia: A local anesthetic is applied to numb the area.
- Guidance: Using imaging techniques like ultrasound, the healthcare provider locates the ilioinguinal and iliohypogastric nerves.
- Injection: The appropriate anesthetic agent and/or steroid is injected using a fine needle.
- Monitoring: The patient is monitored briefly post-injection to ensure there are no immediate adverse reactions.
Tools Used: Ultrasound machine, sterile needles, syringes, anesthetic agents, and steroids.
Anesthesia: Local anesthetic applied at the injection site.
Duration
The procedure typically takes about 30 minutes.
Setting
This procedure is usually performed in an outpatient clinic or a hospital's pain management department.
Personnel
- Pain Specialist or Anesthesiologist
- Nurse or Medical Assistant
Risks and Complications
- Common: Temporary pain at injection site, bleeding, or bruising.
- Rare: Infection, allergic reactions to medications, nerve damage.
Management: Complications are managed with appropriate medications and, if necessary, additional medical intervention.
Benefits
Expected Benefits: Reduced pain and inflammation, with improvement potentially noticed within a few days. Duration of Relief: Can vary from weeks to months depending on the individual.
Recovery
- Post-care: Avoid strenuous activities for the first 24 hours.
- Pain Management: Mild discomfort can be managed with over-the-counter pain relievers.
- Restrictions: No specific restrictions, but patients should monitor for unusual symptoms.
- Follow-up: Typically, a follow-up appointment is scheduled to assess the efficacy of the injection.
Alternatives
- Physical Therapy: Pros - Non-invasive; Cons - May take longer to see results.
- Oral Pain Medications: Pros - Easy to administer; Cons - Potential for side effects and dependency.
- Surgical Intervention: Pros - Definitive treatment in some cases; Cons - Higher risk and longer recovery time.
Patient Experience
During: Patients may feel a slight pinch or pressure at the injection site. After: Some temporary soreness or bruising at the injection site is normal, but this usually resolves within a few days. Pain Management: Over-the-counter pain relief can alleviate post-procedure discomfort.