Bilateral ilioinguinal nerve block decreases morphine consumption in female patients undergoing nonlaparoscopic gynecologic surgery.
BACKGROUND
Bilateral ilioinguinal nerve block may be useful to control postoperative pain in gynecologic surgery, especially hysterectomy.


METHODS
In a prospective, randomized, double-blind study, we compared the combination of ropivacaine and clonidine (block group) versus saline (control group). The main objective of this study was to compare the total dose of morphine required during the first two postoperative days. All patients received antiemetic prophylaxis and multimodal IV analgesia.


RESULTS
Seventy patients were randomized. The total morphine consumption during the first two postoperative days was decreased by 51% in the block group compared with the control group (21 +/- 9 mg vs 41 +/- 24 mg, P < 0.0001). This difference was not only due to morphine titration, but remained significant over the following 2 days. The course of the visual analog scale was equivalent between the two groups. No difference was observed in the side effects of morphine.


CONCLUSIONS
The use of bilateral ilioinguinal nerve block for postoperative analgesia after hysterectomy decreased morphine consumption by one-half during the first two postoperative days without differences in side effects from morphine between groups.
Oriola
Fabienne
F
Department of Anesthesiology B and Medical and Surgical ICU, Amiens University Hospital, Amiens, France.
Toque
Yannick
Y
Mary
Anne
A
Gagneur
Odile
O
Beloucif
Sadek
S
Dupont
Hervé
H
D000328:Adult; D000577:Amides / Q000494:pharmacology; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000494:pharmacology*; D000772:Anesthesia, Local; D003000:Clonidine / Q000494:pharmacology; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D009020:Morphine / Q000494:pharmacology*; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D000077212:Ropivacaine
D000577:Amides; D000701:Analgesics, Opioid; D009020:Morphine; D000077212:Ropivacaine; D003000:Clonidine