Articles
Register for Prospective Randomized Trial of Iliohypogastric-ilioinguinal Nerve Block on Post-operative Morphine Use After Inpatient Surgery of the Female Reproductive Tract
Salim A Wehbe, Labib M Ghulmiyyah, El-Khawand H Dominique, Sarah L Hosford, Carole M Ehleben, Steven L Saltzman and Eric Scott Sills
Research
Journal of
Negative Results in BioMedicine 2008
Published: 28 November 2008
Abstract (provisional)
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 + 5mcg/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 (47.3mg in Group I vs. 45.9mg 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, 23.3h in Group I and 22.8h 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.
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provisional PDF. The fully formatted PDF and HTML versions are in
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Journal of Negative Results in BioMedicine 2008,
7:11doi:10.1186/1477-5751-7-11
An
Open Access Article
