Assessment of postoperative pain and hospital discharge after inguinal and iliohypogastric nerve block for inguinal hernia repair under spinal anesthesia: a prospective study.
OBJECTIVE
This study was designed to evaluate analgesia (pain intensity and analgesic consumption) and the time of discharge of patients who underwent ilioinguinal (II) and iliohypogastric (IH) nerve block associated with wound infiltration with 0.75% ropivacaine, or not, after inguinal hernia repair surgery under spinal anesthesia.


METHODS
This was a prospective, randomized, double-blind study with 34 patients undergoing inguinal hernia repair. Patients were divided into two groups: control (C) and II and IH nerve block (B). Group C (n = 17) received spinal anesthesia with 15 mg hyperbaric 0.5% bupivacaine and Group B (n = 17) received spinal anesthesia with 15 mg hyperbaric 0.5% bupivacaine associated with II and IH nerve block (10 mL of 0.75% ropivacaine) and surgical wound infiltration (10 mL of 0.75% ropivacaine). The following data were analyzed: demographic data, pain intensity according to the visual analog scale (VAS), and number of doses of analgesics (dipyrone, ketorolac and nalbuphine) in the immediate postoperative period, as well as at the time of hospital discharge.


RESULTS
The VAS at rest was significantly lower in Group B compared with Group C (p < 0.05), three hours after the procedure, with no differences on VAS during movement in all postoperative periods. The number of doses of analgesics during the postoperative period was similar in both groups, but patients in Group B were discharged earlier than in Group C.


CONCLUSIONS
II and IH nerve block associated with surgical wound infiltration with 0.75% ropivacaine provides better postoperative analgesia and early hospital discharge in patients undergoing inguinal hernia repair under spinal anesthesia.
Curso de Pós-graduação em Ciências Aplicadas a Cirurgia e Oftalmologia, Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Guilherme de Castro
Gde C
Santos
Gisela Magalhães
GM
Braga
Fábio Lopes
FL
Queiroz
Túlio Pinho
TP
Navarro
Renato Santiago
RS
Gomez
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides; D000775:Anesthesia, Spinal / Q000379:methods; D000779:Anesthetics, Local; D002045:Bupivacaine; D004311:Double-Blind Method; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D000077212:Ropivacaine; D013997:Time Factors; D055815:Young Adult
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D002045:Bupivacaine