The ultrasound transducer is placed superior and medial to the iliac spine on a line (dashed blue line) marked from the anterior superior iliac spine to the umbilicus. A needle is inserted in the skin (red dot) and, with ultrasound guidance, directed toward the ilioinguinal and iliohypogastric nerves, until a "pop" is felt as the needle pierces the external oblique fascia. Local anesthetic (0.25 to 0.5% bupivacaine or 0.5 to 0.75% ropivacaine) is administered.
