Background
Inguinal hernia is a common pediatric condition ,found nearly in 2% of infant males. One of the commonly used blocks in pediatrics is Ilioinguinal/Iliohypogastric (II/IH) nerve blockade which has been shown to be equally effective compared with caudal blockade for inguinal herniotomy. This study aimed to assess whether ultrasound-guided ilioinguinal/ iliohypogastric nerve blocks with local anesthetic would provide comparable intraoperative and postoperative analgesia to blind technique caudal block with local anesthetic in pediatric unilateral inguinal herniotomy.
Patients and methods
We performed a blind prospective randomized clinical trial on 122 pediatric male patients with unilateral inguinal hernia ,ASA (I,II) ,aged 2 to 7 years old and divided them into 2 groups :group I received ultrasound guided ilioinguinal /iliohypogastric nerve block and group II received blind caudal block .we assessed hemodynamics ,pain score(ChIPPS) ,first call for analgesia and complications .
Results
We found a statistically significant lower heart rate and systolic blood pressure in group I (II/IH group) than group II (caudal group). There was statistically significant lower pain score at four hours and at six hours postoperatively in group I compared with group II. In group I, less systemic analgesics were needed within 12 hours. Group I showed no motor block and no urine retention compared to group II .
Conclusion
Ultrasound-guided ilioinguinal and iliohypogastric nerve block was found to be an ideal intraoperative and postoperative analgesic for unilateral inguinal herniotomy in children.
Keywords: pediatric inguinal herniotomy, regional, ilioinguinal/ iliohypogastric block, caudal block