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Prospective randomized trial of iliohypogastric-ilioinguinal nerve block on post-operative morphine use after inpatient surgery of the female reproductive tract.
Wehbe, Salim A; Ghulmiyyah, Labib M; Dominique, El-Khawand H; Hosford, Sarah L; Ehleben, Carole M; Saltzman, Steven L; Sills, Eric Scott
<p>This article is also available from <a href="http://www.biomedcentral.com">www.biomedcentral.com</a></p> <p>OBJECTIVE: To determine the impact of pre-operative and intra-operative ilioinguinal and iliohypogastric nerve block on post-operative analgesic utilization and length of stay (LOS).</p> <p>METHODS: We conducted a prospective randomized double-blind placebo controlled trial to assess effectiveness of ilioinguinal-iliohypogastric nerve block (IINB) on post-operative morphine consumption in female study patients (n = 60). Patients undergoing laparotomy via Pfannenstiel incision received injection of either 0.5% bupivacaine + 5 mcg/ml epinephrine for IINB (Group I, n = 28) or saline of equivalent volume given to the same site (Group II, n = 32). All injections were placed before the skin incision and after closure of rectus fascia via direct infiltration. Measured outcomes were post-operative morphine consumption (and associated side-effects), visual analogue pain scores, and hospital length of stay (LOS).</p> <p>RESULTS: No difference in morphine use was observed between the two groups (47.3 mg in Group I vs. 45.9 mg in Group II; p = 0.85). There was a trend toward lower pain scores after surgery in Group I, but this was not statistically significant. The mean time to initiate oral narcotics was also similar, 23.3 h in Group I and 22.8 h in Group II (p = 0.7). LOS was somewhat shorter in Group I compared to Group II, but this difference was not statistically significant (p = 0.8). Side-effects occurred with similar frequency in both study groups.</p> <p>CONCLUSION: In this population of patients undergoing inpatient surgery of the female reproductive tract, utilization of post-operative narcotics was not significantly influenced by IINB. Pain scores and LOS were also apparently unaffected by IINB, indicating a need for additional properly controlled prospective studies to identify alternative methods to optimize post-surgical pain management and reduce LOS.</p>
Keyword(s): Adult; Analgesics; Opioid; Double-Blind Method; Female; Gynecologic Surgical Procedures; Humans; Laparotomy; Middle Aged; Morphine; Nerve Block; Pain; Postoperative; Medicine and Health Sciences; Obstetrics and Gynecology
Publication Date:
2008
Type: Journal article
Peer-Reviewed: Yes
Institution: Royal College of Surgeons in Ireland
Citation(s): Wehbe SA, Ghulmiyyah LM, Dominique el-KH, Hosford SL, Ehleben CM, Saltzman SL, Sills ES. Prospective randomized trial of iliohypogastric-ilioinguinal nerve block on post-operative morphine use after inpatient surgery of the female reproductive tract. Journal of Negative Results in Biomedicine. 2008;7:11.
File Format(s): application/pdf
Related Link(s): http://epubs.rcsi.ie/obsgynart/7
First Indexed: 2015-07-31 15:36:26 Last Updated: 2018-02-13 07:20:39