Skip to main content
Article
Prospective randomized trial of iliohypogastric-ilioinguinal nerve block on post-operative morphine use after inpatient surgery of the female reproductive tract.
Obstetrics and Gynaecology Articles
  • Salim A Wehbe, Brown University
  • Labib M Ghulmiyyah, American University of Beirut
  • El-Khawand H Dominique, Louisiana State University
  • Sarah L Hosford, Atlanta Medical Center
  • Carole M Ehleben, Atlanta Medical Center
  • Steven L Saltzman, Atlanta Medical Center
  • Eric Scott Sills, Royal College of Surgeons in Ireland
Peer Reviewed
1
Document Type
Article
Publication Date
28-11-2008
Keywords
  • Adult,
  • Analgesics,
  • Opioid,
  • Double-Blind Method,
  • Female,
  • Gynecologic Surgical Procedures,
  • Humans,
  • Laparotomy,
  • Middle Aged,
  • Morphine,
  • Nerve Block,
  • Pain,
  • Postoperative
Comments

This article is also available from www.biomedcentral.com

Abstract

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).

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).

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.

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.

PubMed ID
19040739
DOI Link
10.1186/1477-5751-7-11
Citation Information
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.