Introduction Surgery for vulval cancer includes sampling diagnostic, excisional biopsy and extensive radical surgery. The vulva and perineum are innervated by branches from the ilio-inguinal and pudendal nerves. We describe our experience of axon nerve blocks and outcomes including postoperative pain scores following surgeon administered intraoperative ilio-inguinal and pudendal nerve blocks.
Methods Ilio-inguinal and pudendal nerve block has become routine practice for women undergoing vulval surgery in our cancer centre. In a retrospective chart review, clinical and demographic data, postoperative visual analogue pain scores and use of analgesia were recorded.
Results Eighteen women were included in the analysis. Their median age was 67 (range 34–81) years and thirteen (72%) were over 60 years. Visual analogue scores ranged from 0 to 3 for 17 patients from day 0--1 and 15 patients from days 2--5. Two patients had pain scores > 4 on one or more postoperative day: one had chronic arthralgia and one had received a lower volume of bupivicaine compared to our routine practice. Figure 1 summarizes postoperative analgesia usage for the 18 women.
Conclusion Ilio-inguinal and pudendal nerve block is a feasible and effective strategy for postoperative pain management in women undergoing vulval surgery.
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