The efficacy of ilioinguinal-iliohypogastric and intercostal nerve co-blockade for postoperative pain relief in kidney recipients.
BACKGROUND
Postoperative pain is severe in patients undergoing renal transplantation. Systemic analgesia may produce complications as a result of impaired renal function. We investigated whether combined lower intercostal and Ilioinguinal-Iliohypogastric (IG-IH) nerve block might improve the quality of analgesia and reduce morphine consumption during the first 24 h after surgery.


METHODS
Forty-two patients, scheduled as kidney transplant recipients were randomized into two equal groups and were anesthetized with the same technique. After surgery IG-IH, T11 and T12 intercostal nerves on the side of surgery were blocked by bupivacaine 0.5%. The control group was not blocked. Postoperative pain and total amount of morphine consumption were recorded by a person who was blinded to the allocation.


RESULTS
There were significant differences in median visual analog scale scores (25th-75th) measurements at all time points in the study groups (P < 0.05). The total amount of morphine consumption during 24 h was 12.7 +/- 10.5 mg in the blocked group compared with 34.9 +/- 5.9 mg in the nonblocked group (P < 0.001).


CONCLUSIONS
Combined IG-IH and lower intercostal nerves blockade after renal transplantation significantly reduced postoperative pain and opioid consumption.
Shoeibi
Gita
G
Department of Anesthesiology, Dr Shariati Hospital, Tehran, Iran.
Babakhani
Babak
B
Mohammadi
Sussan Soltani
SS
D000328:Adult; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local; D002045:Bupivacaine; D005260:Female; D006801:Humans; D007001:Hypogastric Plexus; D007367:Intercostal Nerves; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine