The effect of removing iliohipogastric nerve from the suture line on postoperative pain in transverse incisions in obstetric and gynecological surgery: A randomized double-blind controlled study

Objective: In this study, it was aimed to reduce postoperative pain and improve the quality of life of the patient after removal of the ilioinguinal and ilohypogastric nerve endings together with the fatty tissue from the lateral ends of the incision made with a pfhanensteil incision. Material and Methods: In the prospective study conducted in our clinic between December 2022 and February 2023; In this study, 46 pregnant patients who had a Caesarean section with a Pfhanensteil incision in Tekirdağ Namık Kemal University Hospital's Gynecology and Obstetrics Clinic were included. Pregnant patients who met the inclusion criteria were accepted. Our study was conducted on two groups, experimental and control groups, and postoperative pain at the incision line of the patients was compared with VAS scoring and APS-POQ-R-TR scale. Results: When our study was evaluated according to the groups, the ages of the cases, weight and BMI measurements, weeks of gestation, marital status and educational status rates, rates of pain before the operation, types of surgery, use of non-drug methods for pain relief and frequency of incentives for non-drug methods according to groups There was no statistically significant difference between them (p>0.05). While there was no statistically significant difference between the rates of giving information about pain treatment to the patients according to the groups (p>0.05); the usefulness of the information provided differs statistically between the groups (p=0.018; p<0.05). The benefit score of the information given to the experimental group about pain treatment was found to be significantly lower than that of the control group. A statistically significant difference was found between the postoperative 1st day VAS pain scores of the cases according to the groups (p=0.043; p<0.05); VAS scores of the experimental group are lower than the control group. According to the groups, the postoperative 10th day and 1st month VAS pain scores of the cases did not show a statistically significant difference (p>0.05). The change in the postoperative 1st day, 10th day and 1st day VAS pain scores of the experimental group cases was found to be statistically significant (p=0.023; p<0.05). As a result of paired comparisons; The decrease in the postoperative 1st month VAS pain scores of the cases compared to the postoperative 1st day was statistically significant (p=0.045; p<0.05). The change in VAS pain scores at postoperative 1st month compared to postoperative 1st day and postoperative 10th day and postoperative 10th day was not significant (p>0.05). The change in postoperative 1st day, 10th day and 1st day VAS pain scores of the control group cases was found to be statistically significant (p=0.001; p<0.01). As a result of paired comparisons; The decrease in VAS pain scores on the 10th day and postoperative 1st month compared to the postoperative 1st day was statistically significant (p=0.039; p=0.001; p<0.05, respectively). The change in the postoperative 1st month VAS pain scores of the cases compared to the postoperative 10th day was not significant (p>0.05). A statistically significant difference was found between the pain severity and sleep disorder scores of the cases according to the groups (p=0.009; p<0.01); The pain intensity and sleep disorder scores of the experimental group were lower than those of the control group. A statistically significant difference was found between the scores of the subjects' effect on activity according to the groups (p=0.012; p<0.05); The effect of the experimental group on the activity scores is lower than the control group. A statistically significant difference was found between the total scores of the American Pain Society's revised patient care scale for pain according to the groups (p=0.003; p<0.01); The total scores of the experimental group are lower than the control group. Conclusion: In our study, it is aimed to manage postoperative pain by preventing ilioinguinal and iliohypogastric nerve compression. Therefore, our study is a study that can be considered in the prevention of nerve compression in the pfanensteil incision and in the management of postoperative pain. Keywords: Pfanensteil incision , Ilioinguinal iliohypogtric nerve removal. Postoperative groin pain.