A randomized control trial on the efficacy of bilateral ilioinguinal-iliohypogastric nerve block and local infiltration for post-cesarean delivery analgesia

Abstract

Background and Aims: The management of post-cesarean delivery pain is of utmost importance to prevent undesirable outcomes. Local anesthetic wound infiltration and bilateral ilioinguinal-iliohypogastric (ILIH) nerve block are two potential techniques to provide better postoperative analgesia. In this study, these two techniques have been compared for the management of postoperative pain in the elective cesarean section. Materials and Methods: After approval from the institutional ethics committee and informed consent from patients, this study was conducted on 150 patients who underwent elective cesarean section under spinal anesthesia. Patients were allotted into three groups: group C (postoperative sham injection), group L (postoperative infiltration of incision site with 20 mL of 0.5% ropivacaine), and the group I (postoperative bilateral ILIH block with 10 mL of 0.5% ropivacaine on each side under ultrasound guidance). The objectives of our study were to evaluate the duration of analgesia, visual analog scale (VAS) score, and the cumulative analgesic requirement for pain relief and a number of analgesic demands. Student t-test and Mann-Whitney U test were used to compare the analgesic parameters among the groups. Results: Group I had a significantly longer duration of analgesia (515.64 ± 82.87 min) compared to group L (280.87 ± 39.47 min), and group C (246.89 ± 37.85 min). Group I had significantly lower VAS scores compared to the groups L and C. Group I (1.72 ± 0.68) had lower analgesic demands compared to group L (3.26 ± 0.64) and group C (4.62 ± 0.65). The cumulative analgesic requirement was significantly lower in group I. Conclusion: ILIH nerve block has a longer duration of postoperative pain relief in cesarean delivery patients compared to local infiltration and placebo.