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Background: Pain after cesarean section is a common phenomenon. Optimal postoperative pain control is paramount as it facilitates early mobilization of the mother, decrease patient morbidity, improve mother –new born bonding and patient satisfaction. This study was designed to determine the analgesic efficacy of bilateral ilioinguinal and iliohypogastric nerve block for caesareans delivery under spinal anaesthesia in the first 24 post-operative hours, Gondar University hospital, Northwest Ethiopia.
Methods: A total of 80 parturients undergoing caesarean delivery via Pfannenstiel incision under spinal anaesthesia were randomly allocated to receive either bilateral II-IH block with 16 ml of 0.25% bupivacaine per side or no II-IH nerve block. Both groups received scheduled IM diclofenac 75 mg every 8 h and intravenous tramadol for breakthrough pain. Pain was assessed at 0, 4, 6, 8, 12, and 24 h after operation both at rest and on movement using numeric rating scale. Time for first analgesia request and total postoperative analgesia consumption were assessed.
Results: Pain severity was decreased both at rest and on movement at all time intervals for 24 h of operation in the treatment group (P<0.001) except at 0 h. Tramadol consumption was decreased by more than 50% in the treatment group compared to the controls for 24 h following surgery (P<0.001). The first analgesia request time was also significantly prolonged in the intervention group than to the control group (P<0.001).
Conclusion and recommendation: Compared to no intervention, bilateral II-IH blocks in patients undergoing caesarean delivery with Pfannenstiel incision had significantly improved pain relief at rest and with movement and resulted in significantly less tramadol consumption in the first 24 h after surgery. These results support the use of bilateral II-IH blocks as part of a multimodal analgesic regimen.