The Efficacy of Ilioinguinal-Iliohypogastric and Intercostal Nerve Co-Blockade for Postoperative Pain Relief in Kidney Recipients

BACKGROUND: Postoperative pain is severe in patients undergoing renal transplantation. Systemic analgesia may produce complications as a result of impaired renal function. We investigated whether combined lower intercostal and Ilioinguinal-Iliohypogastric (IG-IH) nerve block might improve the quality of analgesia and reduce morphine consumption during the first 24 h after surgery. METHODS: Forty-two patients, scheduled as kidney transplant recipients were randomized into two equal groups and were anesthetized with the same technique. After surgery IG-IH, T11 and T12 intercostal nerves on the side of surgery were blocked by bupivacaine 0.5%. The control group was not blocked. Postoperative pain and total amount of morphine consumption were recorded by a person who was blinded to the allocation. RESULTS: There were significant differences in median visual analog scale scores (25th-75th) measurements at all time points in the study groups (P < 0.05). The total amount of morphine consumption during 24 h was 12.7 +/- 10.5 mg in the blocked group compared with 34.9 +/- 5.9 mg in the nonblocked group (P < 0.001). CONCLUSIONS: Combined IG-IH and lower intercostal nerves blockade after renal transplantation significantly reduced postoperative pain and opioid consumption.