The efficacy of ilioinguinal and iliohypogastric nerve block for postoperative pain after caesarean section

Abstract

Background: The effect of ilioinguinal and iliohypogastric (II-IH) nerve block on postoperative pain is well documented when performed before Caesarean section (CS) but the efficacy remains unclear when performed after the surgical procedure. The aim of this study is to investigate the effect of II-IH nerve block on postoperative pain and analgesic consumption in patients when performed after CS.

Methods: Sixty ASA I- II patients, scheduled for elective CS were included in the study. After general anaesthesia, patients were allocated into 2 groups randomly. In group I bilateral II-IH block has been performed after the skin closure, with 10 ml of 0.5% ropivacaine on each side. In group II sham block had been performed. For postoperative analgesia all patients received tramadol via i.v patient controlled analgesia. Visual analogue scale (VAS) scored tramadol consumption and side effects.

Results: The mean VAS scores in II-IH block group were significantly lower than in sham block group at 6(th), 8(th), 12(th), 24(th) hours at rest (p < 0.05) and at 6(th), 8(th) hours with movement (p < 0.05). Tramadol usage in II-IH block group was significantly less than in sham block group at all estimated time intervals (p < 0.05). Total tramadol consumption was 331 ± 82 mg in II-IH block group and 622 ± 107 mg in sham block group (p < 0.05).

Conclusions: It was observed that II-IH nerve block when performed after the surgery may reduce analgesic consumption after CS.

Keywords: Caesarean Section; Ilioinguinal and Iliohypogastric (II-IH) Nerve Block; Postoperative Analgesia.

Figure 1

Postoperative VAS scores at rest. Data are expressed as mean ± SD. * Statistically significant difference between II-IH block and sham block group (p < 0.05).

Figure 2

Postoperative VAS scores at movement. Data are expressed as mean ± SD. * Statistically significant difference between II-IH block and sham block group (p < 0.05).

Figure 3

Tramadol consumption (mg) at estimated time intervals. Data are expressed as mean ± SD. * Statistically significant difference between II-IH block and sham block group (p < 0,006). (Applied Bonferroni Correction)