Effect of ultrasound-guided ilioinguinal-iliohypogastric nerve block on chronic pain in patients undergoing open inguinal hernia surgery under spinal anesthesia: a randomized double-blind study
Background: Pre-operative ilioinguinal-iliohypogastric nerve block (II-IHNB) has a proven role in lessening acute postoperative pain and opioid consumption following hernia repair. However, its role in preventing post-herniorrhaphy groin pain (PHGP) is still unknown. The current study aims to assess...
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Veröffentlicht in: | The Korean journal of pain 2024, Vol.37 (4), p.332-342 |
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description | Background: Pre-operative ilioinguinal-iliohypogastric nerve block (II-IHNB) has a proven role in lessening acute postoperative pain and opioid consumption following hernia repair. However, its role in preventing post-herniorrhaphy groin pain (PHGP) is still unknown. The current study aims to assess pre-operative II-IHNB's impact on PHGP three and six months after open inguinal hernia repair under spinal anesthesia. Methods: Seventy patients posted for inguinal hernia surgery were randomly allocated into group A (received ultrasound-guided II-IHNB with 10 mL of 0.5% ropivacaine and 4 mg [1 mL] dexamethasone) and group B (received ultrasound-guided II-IHNB with 11 mL of 0.9% normal saline). The time to first analgesic request, pain scores, opioid consumption, DN4 score, and PHGP at 3 and 6 months were analyzed using appropriate statistical tests. Results: The numerical pain rating scale at movement in group A was significantly reduced at all the time intervals of 3, 6, 12, and 24 hours compared to group B. Total opioid usage was lower in group A (3.71 mg [3.90]) versus group B (12.14 mg [4.90]) with a mean difference of -8.43 mg (95% CI -10.54, -6.32), P < 0.001. The time required for the first rescue analgesic was significantly longer in group A (360 min [180-360]) versus (180 min [180-360]) in group B (P < 0.001). However, there was no difference in the incidence of PHGP at three and six months between the two groups. Conclusions: Pre-operative ultrasound-guided II-IHNB reduces postoperative analgesic requirement but does not reduce the incidence of chronic PHGP following hernia surgery at 6 months. |
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However, its role in preventing post-herniorrhaphy groin pain (PHGP) is still unknown. The current study aims to assess pre-operative II-IHNB's impact on PHGP three and six months after open inguinal hernia repair under spinal anesthesia. Methods: Seventy patients posted for inguinal hernia surgery were randomly allocated into group A (received ultrasound-guided II-IHNB with 10 mL of 0.5% ropivacaine and 4 mg [1 mL] dexamethasone) and group B (received ultrasound-guided II-IHNB with 11 mL of 0.9% normal saline). The time to first analgesic request, pain scores, opioid consumption, DN4 score, and PHGP at 3 and 6 months were analyzed using appropriate statistical tests. Results: The numerical pain rating scale at movement in group A was significantly reduced at all the time intervals of 3, 6, 12, and 24 hours compared to group B. Total opioid usage was lower in group A (3.71 mg [3.90]) versus group B (12.14 mg [4.90]) with a mean difference of -8.43 mg (95% CI -10.54, -6.32), P < 0.001. The time required for the first rescue analgesic was significantly longer in group A (360 min [180-360]) versus (180 min [180-360]) in group B (P < 0.001). However, there was no difference in the incidence of PHGP at three and six months between the two groups. Conclusions: Pre-operative ultrasound-guided II-IHNB reduces postoperative analgesic requirement but does not reduce the incidence of chronic PHGP following hernia surgery at 6 months.</description><identifier>ISSN: 2005-9159</identifier><identifier>EISSN: 2093-0569</identifier><language>kor</language><ispartof>The Korean journal of pain, 2024, Vol.37 (4), p.332-342</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,4024</link.rule.ids></links><search><creatorcontrib>Rajendra Kumar Sahoo</creatorcontrib><creatorcontrib>Amit Pradhan</creatorcontrib><creatorcontrib>Priyadarsini Samanta</creatorcontrib><creatorcontrib>Laxman Kumar Senapati</creatorcontrib><creatorcontrib>Ganesh Chandra Satapathy</creatorcontrib><title>Effect of ultrasound-guided ilioinguinal-iliohypogastric nerve block on chronic pain in patients undergoing open inguinal hernia surgery under spinal anesthesia: a randomized double-blind study</title><title>The Korean journal of pain</title><addtitle>The Korean journal of pain</addtitle><description>Background: Pre-operative ilioinguinal-iliohypogastric nerve block (II-IHNB) has a proven role in lessening acute postoperative pain and opioid consumption following hernia repair. However, its role in preventing post-herniorrhaphy groin pain (PHGP) is still unknown. The current study aims to assess pre-operative II-IHNB's impact on PHGP three and six months after open inguinal hernia repair under spinal anesthesia. Methods: Seventy patients posted for inguinal hernia surgery were randomly allocated into group A (received ultrasound-guided II-IHNB with 10 mL of 0.5% ropivacaine and 4 mg [1 mL] dexamethasone) and group B (received ultrasound-guided II-IHNB with 11 mL of 0.9% normal saline). The time to first analgesic request, pain scores, opioid consumption, DN4 score, and PHGP at 3 and 6 months were analyzed using appropriate statistical tests. Results: The numerical pain rating scale at movement in group A was significantly reduced at all the time intervals of 3, 6, 12, and 24 hours compared to group B. Total opioid usage was lower in group A (3.71 mg [3.90]) versus group B (12.14 mg [4.90]) with a mean difference of -8.43 mg (95% CI -10.54, -6.32), P < 0.001. The time required for the first rescue analgesic was significantly longer in group A (360 min [180-360]) versus (180 min [180-360]) in group B (P < 0.001). However, there was no difference in the incidence of PHGP at three and six months between the two groups. Conclusions: Pre-operative ultrasound-guided II-IHNB reduces postoperative analgesic requirement but does not reduce the incidence of chronic PHGP following hernia surgery at 6 months.</description><issn>2005-9159</issn><issn>2093-0569</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>JDI</sourceid><recordid>eNqNjsFKxEAMhosouLj7Drl4HBg7baXeRFZED168L9NO2sYdM2UyFerb-Wa2rg9gCCR__p-PnGWbXNdG6bKqz9ddl6q-KevLbCfyrpcyRuvKbLLvfddhmyB0MPkUrYSJneoncuiAPAXiRbD1ahXDPIbeSorUAmP8RGh8aI8QGNohBl7OoyWGpUebCDkJLDyM_cqBMOLqnYAwYGSyIFPsMc6nHMj461lGSQMK2TuwEC278EFfy0suTI1H1XhiB5ImN2-zi856wd3fvMquH_dvD0_qSJLowE784fn-5TXXeWG0KYwptLmtzH9zP8SLatg</recordid><startdate>2024</startdate><enddate>2024</enddate><creator>Rajendra Kumar Sahoo</creator><creator>Amit Pradhan</creator><creator>Priyadarsini Samanta</creator><creator>Laxman Kumar Senapati</creator><creator>Ganesh Chandra Satapathy</creator><scope>JDI</scope></search><sort><creationdate>2024</creationdate><title>Effect of ultrasound-guided ilioinguinal-iliohypogastric nerve block on chronic pain in patients undergoing open inguinal hernia surgery under spinal anesthesia: a randomized double-blind study</title><author>Rajendra Kumar Sahoo ; Amit Pradhan ; Priyadarsini Samanta ; Laxman Kumar Senapati ; Ganesh Chandra Satapathy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-kisti_ndsl_JAKO2024303433403763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>kor</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rajendra Kumar Sahoo</creatorcontrib><creatorcontrib>Amit Pradhan</creatorcontrib><creatorcontrib>Priyadarsini Samanta</creatorcontrib><creatorcontrib>Laxman Kumar Senapati</creatorcontrib><creatorcontrib>Ganesh Chandra Satapathy</creatorcontrib><collection>KoreaScience</collection><jtitle>The Korean journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rajendra Kumar Sahoo</au><au>Amit Pradhan</au><au>Priyadarsini Samanta</au><au>Laxman Kumar Senapati</au><au>Ganesh Chandra Satapathy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of ultrasound-guided ilioinguinal-iliohypogastric nerve block on chronic pain in patients undergoing open inguinal hernia surgery under spinal anesthesia: a randomized double-blind study</atitle><jtitle>The Korean journal of pain</jtitle><addtitle>The Korean journal of pain</addtitle><date>2024</date><risdate>2024</risdate><volume>37</volume><issue>4</issue><spage>332</spage><epage>342</epage><pages>332-342</pages><issn>2005-9159</issn><eissn>2093-0569</eissn><abstract>Background: Pre-operative ilioinguinal-iliohypogastric nerve block (II-IHNB) has a proven role in lessening acute postoperative pain and opioid consumption following hernia repair. However, its role in preventing post-herniorrhaphy groin pain (PHGP) is still unknown. The current study aims to assess pre-operative II-IHNB's impact on PHGP three and six months after open inguinal hernia repair under spinal anesthesia. Methods: Seventy patients posted for inguinal hernia surgery were randomly allocated into group A (received ultrasound-guided II-IHNB with 10 mL of 0.5% ropivacaine and 4 mg [1 mL] dexamethasone) and group B (received ultrasound-guided II-IHNB with 11 mL of 0.9% normal saline). The time to first analgesic request, pain scores, opioid consumption, DN4 score, and PHGP at 3 and 6 months were analyzed using appropriate statistical tests. Results: The numerical pain rating scale at movement in group A was significantly reduced at all the time intervals of 3, 6, 12, and 24 hours compared to group B. Total opioid usage was lower in group A (3.71 mg [3.90]) versus group B (12.14 mg [4.90]) with a mean difference of -8.43 mg (95% CI -10.54, -6.32), P < 0.001. The time required for the first rescue analgesic was significantly longer in group A (360 min [180-360]) versus (180 min [180-360]) in group B (P < 0.001). However, there was no difference in the incidence of PHGP at three and six months between the two groups. Conclusions: Pre-operative ultrasound-guided II-IHNB reduces postoperative analgesic requirement but does not reduce the incidence of chronic PHGP following hernia surgery at 6 months.</abstract><oa>free_for_read</oa></addata></record> |
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source | KoreaMed Synapse; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; PubMed Central Open Access |
title | Effect of ultrasound-guided ilioinguinal-iliohypogastric nerve block on chronic pain in patients undergoing open inguinal hernia surgery under spinal anesthesia: a randomized double-blind study |
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