title: Development and evaluation of combined rectus sheath and ilioinguinal blocks for abdominal gynaecological surgery.
abstract: We describe the development of a technique of combined rectus sheath and ilioinguinal blocks for patients undergoing abdominal gynaecological surgery, and its use in a series of 37 patients (21 midline and 16 transverse incisions). Up to 60 ml of bupivacaine 0.25% with adrenaline 1:400,000 was used, depending on the patient's weight. Median (interquartile range) total morphine requirement (including 0.15 mg x kg(-1) given intra-operatively) up to 48 h after surgery was 0.34 (0.2-0.38) [corrected] mg x kg(-1) for midline incisions and 0.47 (0.35-0.64) [corrected] mg x kg(-1) for transverse incisions; no other systemic opioids were given. Six-hourly pain scores within the first 48 h after surgery were < or =1 (mild pain) in 11 out of 21 (52%) and < or =2 (moderate pain) in 18 out of 21 (86%) patients with midline incisions and in 5 out of 16 (31%) and 13 out of 16 (81%) patients with transverse incisions, respectively. No patient had emetic symptoms worse than mild nausea during the 48-h postoperative study period.
authors.affiliation: Magill Department of Anaesthetics, Chelsea Westminster Hospital, London, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Yentis
authors.forename: P
authors.initials: P
authors.lastname: Hills-Wright
authors.forename: O
authors.initials: O
authors.lastname: Potparic
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000627:therapeutic use; D002045:Bupivacaine / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine