[Efficacy of the ilioinguinal and iliohypogastric block in the treatment of the postoperative pain of inguinal herniorrhaphy].
BACKGROUND
The ileoinguinal-ileohypogastric block (IHB) improves pain control in inguinal hernioplasty.


OBJECTIVE
To determine the efficacy of the IHB on the treatment of postoperative pain in inguinal herniorrhaphy, and to compare the effect of its use before and after incision for diminishing pain and postponing the first dose of analgesia.


METHODS
Sixty-eight patients scheduled for inguinal herniorrhaphy with mesh were enrolled and distributed randomly in 4 groups as follows: 1) IHB before incision using 0.25 ml/kg bupivacaine 0.5% with no vasoconstrictor; 2) IHB after incision with the same dose of bupivacaine; 3) IHB before incision with 0.25 ml/kg of serum; and 4) IHB after incision with 0.25 ml/kg of serum. Pain was evaluated on visual analog scales employing facial expressions and verbal description, a patient questionnaire and time elapsing between surgery and the first dose of analgesia. The evaluations were performed in the postoperative recovery unit and on the ward 8 and 24 hours after surgery.


RESULTS
The total overall score for postoperative pain was lower in the bupivacaine group than in the placebo group (9.2 +/- 4.4 and 1.5 +/- 3.9, respectively; p = 0.026). The first dose of analgesia was given to those who received placebo between the second and third hour after surgery, whereas it was given between the fourth and fifth hour to the bupivacaine group. No significant differences were found between infiltration before and after incision.


CONCLUSIONS
IHB decreases pain, delaying the need for a first dose of analgesic and improving patient comfort. Its use is therefore recommended for relief of postoperative pain.
Abad-Torrent
A
A
Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Institut Català de la Salut, Hospital de Viladecans, Barcelona.
Calabuig
R
R
Sueiras
A
A
Casasin
T
T
Ramón
C
C
Pelegrí
D
D
Izquierdo
E
E
Faura
A
A
Linares
M J
MJ
D004311:Double-Blind Method; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000628:therapy*