痛みと緩和のジャーナル

抽象的な

A Study on Effectiveness of Ilioinguinal and Iliohypogastricnerve Block at the Time of Wound Closure for Postoperative Pain Relief in Inguinal Hernia Repair

Aye Thandar Htun

This study was to evaluate the effect of an ilioinguinal-iliohypogastric nerve block with bupivacaine 0.25% on the postoperative analgesia and subsequent analgesic requirements in patients undergoing unilateral open inguinal herniorrhaphy under spinal anaesthesia. Fifty consenting American society of anaesthesiologists (ASA) score I-II patients scheduled for unilateral inguinal herniorrhaphy procedures were given spinal anaesthesia with hyperbaric 0.5% bupivacaine. In a randomized fashion, half of them received an ilioinguinal-iliohypogastric nerve block (IINB) with 30 millilitre (ml) of 0.25% bupivacaine at the time of wound closure and then other half with intramuscular injection of diclofenac sodium 75 milligram (mg). The patients were observed for postoperative 24 hour, such as duration of postoperative analgesia, first on demand analgesic and total analgesic doses, 4 hourly visual analogue scales (VAS), complications of nerve block, 4 hourly haemodynamic changes and assessed patient’s satisfaction at postoperative 12 hour in both groups. The results showed that in comparison with diclofenac group (group B), significantly longer duration of postoperative analgesia in IINB group (group A) (P<0.05%) and the amount required was also significantly less postoperatively in 24 hour (P<0.05%). No complications occurred. Patient’s satisfaction score at postoperative 12 hour was higher in group (A) patients (P<0.05%). There was no significant difference in haemodynamic changes between the two groups. It is concluded that the use of IINB with bupivacaine 0.25% at the time of wound closure in patients undergoing unilateral open inguinal herniorrhaphy under spinal anaesthesia decreased pain and analgesic requirements in the postoperative 24 hour and increased patient’s satisfaction score at postoperative 12 hour.