Vallejo Manuel C, Steen Talora L, Cobb Benjamin T, Phelps Amy L, Pomerantz Joel M, Orebaugh Steven L, Chelly Jacques E
Department of Anesthesiology, Magee-Womens Hospital of UPMC, 300 Halket Street, Pittsburgh, PA 15213, USA.
ScientificWorldJournal. 2012;2012:107316. doi: 10.1100/2012/107316. Epub 2012 Dec 4.
The ilioinguinal-iliohypogastric (IIIH) block is frequently used as multimodal analgesia for lower abdominal surgeries. The aim of this study is to compare the efficacy of IIIH block using ultrasound visualization for reducing postoperative pain after caesarean delivery (CD) in patients receiving intrathecal morphine (ITM) under spinal anesthesia. Participants were randomly assigned to 1 of 3 treatment groups for the bilateral IIIH block: Group A = 10 mL of 0.5% bupivacaine, Group B = 10 mL of 0.5% bupivacaine on one side and 10 mL of a normal saline (NSS) placebo block on the opposite side, and Group C = 10 mL of NSS placebo per side. Pain and nausea scores, treatment for pain and nausea, and patient satisfaction were recorded for 48 hours after CD. No differences were noted with respect to pain scores or treatment for pain over the 48 hours. There were no differences to the presence of nausea (P = 0.64), treatment for nausea (P = 0.21), pruritus (P = 0.39), emesis (P = 0.35), or patient satisfaction (P = 0.29). There were no differences in pain and nausea scores over the measured time periods (MANOVA, P > 0.05). In parturients receiving ITM for elective CD, IIIH block offers no additional postoperative benefit for up to 48 hours.
髂腹股沟-髂腹下神经（IIIH）阻滞常用于下腹部手术的多模式镇痛。本研究旨在比较在脊髓麻醉下接受鞘内吗啡（ITM）的剖宫产（CD）患者中，使用超声可视化进行IIIH阻滞减轻术后疼痛的效果。参与者被随机分配到双侧IIIH阻滞的3个治疗组之一：A组 = 10 mL 0.5%布比卡因，B组 = 一侧10 mL 0.5%布比卡因，另一侧10 mL生理盐水（NSS）安慰剂阻滞，C组 = 每侧10 mL NSS安慰剂。记录CD后48小时的疼痛和恶心评分、疼痛和恶心的治疗情况以及患者满意度。在48小时内，疼痛评分或疼痛治疗方面未发现差异。在恶心的存在（P = 0.64）、恶心的治疗（P = 0.21）、瘙痒（P = 0.39）、呕吐（P = 0.35）或患者满意度（P = 0.29）方面也没有差异。在测量时间段内，疼痛和恶心评分没有差异（多变量方差分析，P > 0.05）。对于接受ITM进行择期CD的产妇，IIIH阻滞在长达48小时内没有额外的术后益处。
