Ultrasound-guided serial ilioinguinal nerve blocks for management of chronic groin pain secondary to ilioinguinal neuralgia in adolescents.

We examined the efficacy of serial ilioinguinal nerve blocks using ultrasound guidance for management of chronic inguinal pain secondary to persistent ilioinguinal neuralgia in adolescents. This case series consists of two adolescents who had persistent inguinal pain secondary to ilioinguinal neuralgia who were treated with conventional pain medications that did not relieve the pain. One patient had pain immediately following surgery while the other had pain several months after an injury. Serial ilioinguinal nerve blocks were performed with local anesthetic solution using ultrasound guidance in an outpatient setting. Both the adolescents had complete relief of pain symptoms and were able to resume normal activities. There were no adverse effects associated with the blocks. Performance of serial ilioinguinal nerve blocks using ultrasonography in an outpatient setting in adolescents and adolescents with ilioinguinal neuralgia may reduce pain and allow these adolescents to resume their normal activities.

Psychosocial evaluation of bariatric surgery candidates: a survey of present practices.

OBJECTIVE: Successful outcome for bariatric surgery is largely dependent on patients' ability to adhere to postoperative behavior changes. A thorough psychological evaluation is often required before patients' approval for surgery. In addition to a standard psychiatric interview, assessment of behavioral components specific to this surgery seems indicated. No uniform guidelines exist on how to conduct such an evaluation. This survey was designed to collect information on the level of involvement of mental health professionals with bariatric surgery programs and their approach to evaluating bariatric surgery candidates. METHODS: Surveys about psychological evaluation practices were mailed to 188 bariatric surgery programs. Eighty-one surveys were returned. RESULTS: Eighty-eight percent of programs require patients to undergo a psychological evaluation and almost half require formal standardized psychological assessment. Current illicit drug use, active symptoms of schizophrenia, severe mental retardation, and lack of knowledge about the surgery were the most commonly cited contraindications, preventing patients from gaining approval for surgery. DISCUSSION: The majority of programs use psychological evaluations; however, the exclusion criteria for surgery vary greatly. Establishing uniform guidelines for the screening of bariatric surgery candidates is necessary. Suggestions on how to begin this process are provided. More research about behavioral and cognitive predictors of postsurgical success is needed.