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ANALGESIA

Bilateral Ilioinguinal Nerve Block Decreases Morphine Consumption in Female Patients Undergoing Nonlaparoscopic Gynecologic Surgery

Fabienne Oriola, MD^*, Yannick Toque, MD^*, Anne Mary, MD^*, Odile Gagneur, MD, Sadek Beloucif, MD, PhD^*, and Hervé Dupont, MD, PhD^*

From the *Department of Anesthesiology B and Medical and Surgical ICU and Department of Gynecologic Surgery, Amiens University Hospital, Amiens, France.

Abstract

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.

CONCLUSION: 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.