The effect of ilioinguinal-iliohypogastric block with or without intravenous paracetamol for pain relief after caesarean delivery

Introduction and objective: ABSTRACT Aims: We aimed in this study to compare the postoperative analgesic efficacy of Ilioinguinal-Iliohypogastric (IHII) nerve block with or without intravenous (iv) paracetamol in patients undergoing caesarean section. Materials and methods: Ninety primiparous or multiparous women who had a single pregnancy and were scheduled for elective caesarean section under general anaesthesia were enrolled in the study. While patients in Group M (n=30) were given only Patient-controlled intravenous analgesia (PCIA) with morphine postoperatively, the patients in Group MB (n=30) were employed bilaterally IHII nerve block before extubation in addition to PCIA with morphine postoperatively. Patients in Group MBP (n=30), IHII nerve block before extubation and intravenous (IV) paracetamol were employed in addition to the PCIA with morphine postoperatively. Visual analogue scale scores (VAS), sedation scores, and status of satisfaction and morphine consumption of patients at 1^st, 4^st, 8^st, 12^st, 18^st and 24^st hours after the operation and morphine related side effects were recorded. Results: Postoperative cumulative morphine consumption (mg) for 24 hours was significantly higher in Group M (50.9 ± 11.7) than Group MB (36.2 ± 10.7) and Group MBP (16.4 ± 6.6), (p<0.001, for both). Patients in group M (n=23, %76) had a higher rate of nausea and vomiting compared to the patients in group MB (n=12, 41%) and group MBP (n=3, %11) (p<0.001, for both). Postoperative pruritus was observed more frequently among patients in group M (n=13, 43%) compared with group MB (n=6, 20%) and group MBP (n=5, 16%) (p<0.05, p=0.001; respectively). Conclusion: We conclude that the use of IHII nerve block with or without IV paracetamol reduces postoperative PCIA morphine consumption providing a safe and effective postoperative analgesia with good patient satisfaction. Also, this reduction is associated with a decrease in the incidence of morphine related side effects.