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Title: ilioinguinal-iliohypogastric peripheral nerve block for analgesia after lower segment caesarean section, observational cohort study done in tikur anbessa specialised hospital between august 07,2017 to october 06,2017
???metadata.dc.contributor.*???: Wosenyeleh Admasu (B.SC. M.SC in Anesthesia)
Alazar Kefiyalew
Keywords: Postoperative caesarean section pain
Issue Date: Oct-2017
Publisher: AAU 2017
Abstract: Introduction: Postoperative caesarean section pain is an unpleasant experience. Provision of effective postoperative analgesia is of key importance in this subgroup of parturient to facilitate early ambulation, infant care and prevention of postoperative morbidity. Objective: To assess and compare the post lower segment caesarean section pain scale in parturient undergoing surgery under spinal anesthesia with or without iliohypogastric and ilioinguinal nerve block at Tikur Anbessa hospital. Methods: The study was observational cohort study carried out at Tikur Anbessa hospital. A total of 56 ASA I and ASAII parturient for elective LSCS under spinal anesthesia were studied. The data were analyzed using two independent sample t-tests for demographic parameters. For tramadol consumption, time to first analgesia request and NRS was done using Manny Whitney test. Chi Square test was used to study the association between different parameters measured. Box and Whisker plot were used to show a median pain score between groups and statistical significant were stated at P-value <0.05 with a power of 80%. Result: At all the time interval low pain score was observed in BIIIHNB group with a P-value of <0.05.The duration of analgesia was prolonged in BIIIHNB group as compared to non-exposed group. The median time to first dose of Tramadol in exposed group 250(250-1440) minutes was observed to be longer than non-exposed group 89(75-89) minutes. Decreased consumption of Tramadol was observed in exposed group 125(0-150) mg as compared to non-exposed group 250(0mg) and these difference were statistically significant (P-value <0.0001). The incidence of nausea associated with Tramadol was also significantly lower with exposed group (P-value<0.003). Conclusion and Recommendation: Bilateral ilioinguinal and iliohypogastric nerve block using plain Bupivacaine, in combination with intrathecal Bupivacaine results in low pain scores following LSCS. Thus we conclude that adequate postoperative pain relief is provided with the BIIIHNB, it significantly lowers the consumption of and side effects associated with Tramadol.
Description: Thesis submitted to school of medicine, department of anesthesia for partial fulfilment of the requirements of in anesthesia.
Appears in Collections:Thesis - Anesthesia

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