Surgeon-administered ilioinguinal and pudendal nerve blocks for vulval
oncology surgery: An observational evaluation study with Visual Analogue
Pain Scoring Shahabuddin Y., Gleeson N., Maguire PJ. Department of
Gynaecological Oncology, St James’s Hospital, Dublin 8, Ireland.
Objective To assess pain scores and requirement for parenteral and oral
analgesia in the postoperative period following vulval surgery with
blockade of the ilioinguinal nerve (IIN) and pudendal nerve (PN). Design
An observational study of consecutive patients undergoing major vulval
and/or related groin surgery. Sampling biopsies were excluded. Setting
Women undergoing vulval surgery in a tertiary cancer centre. Population
or Sample Eighteen women were included in the analysis. Median age 67
(range 34-81) years and thirteen (72%) were >60 years.
Methods Levobupivacaine 0.25% (2.5mg/ml) or 0.5% (5mg/ml) was
administered at four sites (2 sites abdominally for IIN block and 2
sites for PN block) with dosage calculated based on the patient’s
weight. Patients were invited to record visual analogue pain scores
(VAS) days 1-5 postoperatively. Use of postoperative analgesia was
recorded. Main Outcome Measures VAS and use of postoperative analgesia.
Results VAS ranged from 0 to 3 for seventeen patients from day 0 to day
1 and fifteen patients from day 2 to day 5. Two patients had pain scores
>4 on one or more postoperative days: one had chronic
arthralgia and one had received a lower volume of bupivacaine.
Conclusions Ilio-inguinal and pudendal nerve block is a feasible and
effective strategy for postoperative pain management in women undergoing