II and IH block ultrasound probe placement and ultrasound image

For the ilioinguinal and iliohypogastric nerve block, the ultrasound probe is placed just cephalad and medial to the ASIS, oriented along a line between the ASIS and the umbilicus. The internal oblique and transverse abdominis muscles are visualized, as in the image above. The needle is inserted in-plane to the transducer, and the tip is placed in the plane between these two muscles, as shown by the arrow in the image. After negative aspiration, 10 mL of LA is injected in 5-mL increments, with gentle aspiration between injections. LA may be seen expanding the fascial plane, as shown in the yellow ovals.