Analgesic Efficacy of Bilateral Ilioinguinal and Iliohypogastric Nerve Block for Post Caesarean Delivery Under Spinal Anaesthesia, 2016. Double blind randomized Study

Nigatu, Yonas Addisu; Gebremedhn, Endale Gebreegziabher; Tawuye, Hailu Yimer; Gebregzi, Amare Hailekiros

doi:10.4172/2155-6148.1000751

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…In agreement with our results, Nigatu et al reported a significant decrease in pain numerical rating scale during rest or movement in the nerve block group (P < 0.05). The nerve block group had significantly lower pain scores than controls at all measurement times (23). Consistent with our results, Sakalli et al reported that the iliohypogastric ilioinguinal nerve block was significantly associated with lower VAS scores than the sham block.…”

Section: Discussionsupporting

confidence: 92%

“…Also, the number of patients requiring rescue analgesia was lower in the block group than in the control group (59.4 vs. 100%, respectively, P < 0.001). In line with our findings, another study reported a significantly longer time to the first analgesic request in the nerve block group than in controls (12 in cases vs. 4 hours; P < 0.001) (23). Yucel et al also reported that the first analgesic request time was significantly longer in the nerve block group than in controls (26).…”

Section: Discussionsupporting

confidence: 91%

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Ilioinguinal and Iliohypogastric Nerve Block for Acute and Chronic Pain Relief After Caesarean Section: A Randomized Controlled Trial

2022

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Background: There is an increasing cesarean section (CS) rate in Egypt. Multiple methods are used to manage pain after CS. Objectives: This study aimed to assess the effect of ultrasound-guided bilateral ilioinguinal and iliohypogastric nerve block on pain reduction after CS. Methods: We classified 64 cases of elective CS into two equal groups. The block group underwent the nerve block, and the control group did not. Postoperative pain, morphine consumption, time to analgesic request, and complications were compared between the two groups. Results: No significant difference was detected between the two groups regarding patient characteristics or operation duration. However, pain scores during rest and movement were significantly lower in the block group than in controls, especially within the first 12 hours following the operation. Morphine consumption was significantly lower in the block group (4.53 ± 1.456) in group B vs. (8.87 ± 2.013) in group C with P-value < 0.001. Time to the first rescue analgesia was significantly longer in the intervention group than in the other group (12.25 vs. 3.81 hours). Pruritis and nausea incidence was significantly higher in controls than in the block group. The incidence of chronic postoperative pain was significantly lower in the block group. Conclusions: The ilioinguinal and iliohypogastric nerve block is efficient and safe for managing postoperative pain following CS. It is associated with significant improvement of acute and chronic pain after such operations.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Ilioinguinal and Iliohypogastric Nerve Block for Acute and Chronic Pain Relief After Caesarean Section: A Randomized Controlled Trial

2022

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“…We included 114 trials (8730 women) in our final network analysis, 73 (64%) of which reported the primary outcome of morphine equivalent dose in the first 24 postoperative hours for 5126 (59%) women (Fig. 1 and online Supporting Information, Table S1) [14–127]. Placebo vs. transversus abdominis plane injection in 11 trials was the most common direct comparison.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of regional blocks or local anaesthetic infiltration for analgesia after caesarean delivery: a network meta‐analysis of randomised controlled trials

et al. 2021

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Caesarean delivery is common and can cause severe postoperative pain but injection of local anaesthetic at various sites for regional blocks or local anaesthetic infiltration may reduce this. We aimed to compare and rank these sites. We searched PubMed, Google Scholar, EMBASE and CENTRAL to June 2021 for randomised controlled trials and performed a random-effects Bayesian model network meta-analysis. The primary outcome was dose of parenteral morphine equivalents in the first 24 postoperative hours. We used surface under cumulative ranking probabilities to order techniques. We analysed 114 trials (8730 participants). The ordered mean (95% credible interval) reduction in morphine equivalents, from 34 mg with placebo, were as follows: ilioinguinal 15 (1-32) mg; ilio-inguinal-iliohypogastric 13 (6-19) mg; transversalis fascia 11 (4-26) mg; erector spinae 11 (10-32); transverse abdominis 9 (4-13) mg; wound catheter infusion 8 (2-15) mg; quadratus lumborum 8 (1-15) mg; wound infiltration 8 (2-13) mg; and no intervention À4 (À10 to 2) mg. Ordered efficacies for injection sites were different for other relevant outcomes, including pain (to 4-6 h and to 24 h) and time to rescue analgesia: there was no single preferred route of injection. The ordered mean (95% credible interval) reduction in dynamic pain scores (0-10 scale) at 24 h compared with placebo were as follows: wound infusion 1.2 (0.2-2.1); erector spinae 1.3 (À0.5 to 3.1); quadratus lumborum 1.0 (0.1-1.8); ilio-inguinaliliohypogastric 0.6 (À0.5 to 1.8); transverse abdominis 0.6 (À0.1 to 1.2); wound infiltration 0.5 (À0.3 to 1.3); transversalis fascia À0.8 (À3.4 to 1.9); ilio-inguinal À0.9 (À3.6 to 1.7); and no intervention À0.8 (À1.8 to 0.2). We categorised our confidence in effect sizes as low or very low.

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“…1). 7,9,[22][23][24][25][26][27][28][29][30][31][32] Of these, 433 patients were enrolled in the II-IH block group and 425 were assigned to the control group. The characteristics of the included studies are shown in Table 1.…”

Section: Comprehensive Literature Searchmentioning

confidence: 99%

The analgesic effectiveness of ilioinguinal-iliohypogastric block for caesarean delivery

Singh

Makkar

Bhatia

et al. 2020

European Journal of Anaesthesiology

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BACKGROUND An effective analgesia strategy following caesarean delivery should be designed to improve fetomaternal outcomes. Much recent research has focused on the efficacy of ilioinguinal-iliohypogastric (II-IH) block for providing such analgesia. DESIGN A systematic review and meta-analysis of randomised controlled trials. OBJECTIVES To investigate the effectiveness of II-IH block in patients undergoing caesarean delivery. The primary outcome was the cumulative parenteral morphine equivalents at 24 h. Pain scores at 4 to 6 and 24 h postsurgery, time to first rescue analgesia and adverse effects were the secondary outcomes analysed. DATA SOURCES Two reviewers searched independently PubMed, Embase, Google Scholar and the Cochrane central registers of a controlled trial from their inception until June 2020. METHODOLOGY Prospective randomised control trials comparing II-IH block with either systemic analgesia alone or a placebo block (non-active controls) were eligible for inclusion. Only trials that reported their methods comprehensibly and transparently were included. Cochrane methodology was used to assess the risk of bias. Data are presented as mean difference with 95% confidence interval (CI). RESULTS Thirteen trials comprising a total of 858 patients were included. Opioid (intravenous morphine equivalents) consumption was reduced by 15.57 mg (95% CI −19.87 to −11.28; P < 0.00001; I 2 = 95%) during the first 24 h in patients receiving II-IH block when compared with placebo or no block. Patients receiving general anaesthesia showed a greater reduction in morphine requirement at 24 h than those receiving neuraxial anaesthesia. Adequate ‘information size’ for the above outcome was confirmed with trial sequential analysis to rule out the possibility of a false-positive result. II-IH also significantly reduced pain scores at rest more so at 4 to 6 h than at 24 h. CONCLUSIONS Our study suggests that the use of II-IH blocks is associated with a lower 24 h requirement for intravenous morphine equivalents in patients undergoing caesarean delivery. However, given the methodological limitations, data should be interpreted with caution until more studies are available.

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Analgesic Efficacy of Bilateral Ilioinguinal and Iliohypogastric Nerve Block for Post Caesarean Delivery Under Spinal Anaesthesia, 2016. Double blind randomized Study

Cited by 5 publications

References 26 publications

Ilioinguinal and Iliohypogastric Nerve Block for Acute and Chronic Pain Relief After Caesarean Section: A Randomized Controlled Trial

Ilioinguinal and Iliohypogastric Nerve Block for Acute and Chronic Pain Relief After Caesarean Section: A Randomized Controlled Trial

Efficacy of regional blocks or local anaesthetic infiltration for analgesia after caesarean delivery: a network meta‐analysis of randomised controlled trials

The analgesic effectiveness of ilioinguinal-iliohypogastric block for caesarean delivery

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