Abstract:Objective To report the anesthetic effect of iliohypogastric or ilioinguinal nerve block in pediatric inguinal region surgery.Methods A total of 120 pediatric patients from March to December in 2015 were randomly divided into two groups (n=60):IINB groupand Caudal block group,IINB group received 1%lidocaine and 0.15%ropivacaine at 0.3-0.5 ml/kg,Caudal block group received 1%lidocaine and 0.15%ropivacaine at 0.8 ml/kg.The vital signs of mean arterial pressure (MAP)and heart rate (HR)were recorded in four time points during surgery:the time of nerve block (T1),the skin incision(T2),ligating hernial sac(sheath dcs)(T3),waking time(T4),intraoperation and postoperation adverse events,the total dosages of propofol,the recover time from anesthesia,surgery time were also recorded,Face legs activity cry consolability(FLACC)score was used to assess the pain score postoperatively at 2,4,6 h postoperation respectively. Results In IINB group,the difference of MAP、HR were no statistical significance (P>0.05).In Caudal block group,MAP at T2,T4,and HR at T4were higher than those at T1,the differences were statistical significance(P<0.05);MAP at T3,HR at T2were significantly higher than those at T1,the differences were significantly statistical significance(P<0.01).MAP at T3,T4,and HR at T2in IINB group were significantly lower than those in Caudal block group (P<0.01),HR at T3,T4in IINB group were lower than those in Caudal block group (P<0.05),the adverse events in IINB group were significantly less,the recover time from anesthesia in IINB group were significantly shorter than those in Caudal block group (P<0.01),the total dosages of propof'ol in IINB group were less than those in Caudal block group(P<0.05),the FLACC pain scores at 4 h postoperation in IINB group were lower than those in Caudal block group(P<0.05),the FLACC pain scores at 6 h postoperation in IINB group were significantly lower than those in Caudal block group(P<0.01).Conclusion The anesthetic effect of IINB is better for inguinal region surgery in pediatrics,the anesthetic method of IINB has clinical value and it′s worthy of spreading to clinical application.
Fredrickson MJ,Paine C,Hamill J.Improved analgesia with the ilioinguinal block compared to the transverses abdominis plane block after pediatric inguinal surgery:a prospective randomized trial[J].Pediatr Anaesth,2010,20(11):1022-1027.
[14]
Suresh S,Sawardekar A,Shah R.Ultrasound for regional anesthesia in children[J].Anesthesiol Clin,2014,32(1):263-279.
[15]
Suresh S,Schaldenbrand K,Wallis B,et al.Regional anaesthesia to improve pain outcomes in paediatric surgical patients:a qualitative systematic review of randomized controlled trials[J].Br J Anaesth,2014,113(3):375-390.
Khosmvi MB,Khezri S,Azemati S.Tramadol for pain relief in children undergoing herniotomy:a comparison with ilioinguinal and iliohypogestric blocks[J].Pediatr Aneath,2006,16(1):54-57.