Genitofemoral Nerve Block and Intraoperative Analgesia in Children During Inguinal Hernia Repair (original) (raw)
Related papers
2012
Background: Inguinal hernia repair in children is one of the commonest surgical procedures. As a day-case procedure, it requires adequate post-operative pain control. A prospective randomized double-blinded study was designed to compare the effectiveness of postoperative pain control and incidence of complications between combined ilioinguinal/iliohypogastric nerve block and intravenous morphine. Methods: Sixty patients aged 2-12 years were randomly allocated to two groups of thirty. One group received intravenous morphine 100 microgram/kg before skin incision and the other had an ilioinguinal and iliohypogastric nerve block with 0.5% bupivacaine (0.25 ml/kg) also before skin incision. All patients have received standardized anaesthesia. Pain was assessed using 0- 10 scale at 0.30 minutes and 1, 2, 3 and 4 hours postoperative. Time to first analgesia, number of paracetamol doses and the incidence of respiratory depression, vomiting and itching were assessed during the first 24 hours...
Background: For postoperative pain relief in patients undergoing open inguinal hernia repair both TAP block and combined ilioinguinal-iliohypogastric blocks are used under ultrasound guidance. Materials and Methods: In this prospective randomised controlled study, 60 patients of ASA physical status I and II belonging to age group of 18-60years undergoing elective open inguinal hernia repair surgery under sub-arachnoid block were randomly allocated into 2 groups o30patients each, Group A (Transversesabdominisplane block) and Group B (Ilioinguinal-iliohypogastricnerve block). Group A received 20ml of 0.25%Bupivacaine for transversesabdominis planeblock and group B received 20ml of 0.25% Bupivacaine for ilioinguinal-iliohypogastric nerve block.Both groups of patients were monitored for postoperative pain for the next 24 hours.Postoperative rescue analgesia was with intravenous tramadol for the first 4 hrs and later with injection diclofenac intramuscularly.Total analgesic consumption in the first 24 hours postoperative period was the primary objective,.secondary objectives were intraoperative hemodynamics,number of attempts,time required for performing the block and postoperative pain scores were evaluated. Results: There was no difference in age, BMI,and duration of surgery between two groups. Postoperative analgesia was better with ilioinguinal-iliohypogastric block when compared to transverse abdominis plane block and rescue analgesia was lesser with groupB when compared to groupA. The postoperative analgesia was significantly prolonged with ilioinguinal-iliohypogastric group (p<0.05) when compared to transverse abdominis group. Conclusion: Ilioinguinal-iliohypogastric nerveblock provide better postoperative analgesia when compared to TAP block for open inguinal hernia repair.
2016
Inguinal hernia repair is the most frequent surgical procedure in early childhood. We designed a randomized, double-blind controlled study to compare the effects of caudal anesthesia, ilioinguinal/iliohypogastric (II/IH) nerve block, and instillation to the wound-site using bupivacaine on postoperative analgesia. Seventy-five ASA status I-II children aged 2 to 7 years who were scheduled for elective unilateral inguinal herniorrhaphy were enrolled inthe study. Patients were divided into three groups. In the caudal anesthesia (CA) group, the caudal block was performed with the child in the left lateral decubitus position before the surgery with 0.5 ml/kg 0.25% bupivacaine. In the II/IH group, the II/IH nerve block was performed by the anatomic landmarks technique with 0.3 ml/kg 0.25% bupivacaine before the surgery. In the wound instillation (I) group, after the surgical closure of the fascia transversalis, patients received wound instillation with 0.2 ml/kg 0.5% bupivacaine, administe...
Pediatric Anesthesia, 2002
Background: We attempted to determine the ef®cacy of a one plane ilioinguinal and iliohypogastric nerve block with a single shot and double shot techniques. Methods: In a randomized single blind study, 90 children, aged 2±12 years, received a single shot (SS) or a double shot (DS) technique for ilioinguinal and iliohypogastric (IG±IH) nerve block for inguinal hernia repair. In the SS group, 0.25 mlákg ±1 of 0.25% bupivacaine was given one ®ngerbreadth medial to the anterior superior iliac spine under the external oblique aponeurosis. In the DS group, one-third of the total dose of bupivacaine was given as for the SS group. The remaining two-thirds was deposited 0.5 cm above and lateral to the mid-inguinal point deep to the external oblique aponeurosis. Results: The success rates of both techniques were similar, at 72%, although the presence of local anaesthetic in the inguinal canal was signi®cantly higher with the DS technique. The incidence of femoral nerve block was 4.5% with the SS and 9% with the DS technique (P > 0.05). Parental satisfaction with postoperative pain relief was high, at 94%. Conclusions: The DS technique, while technically more dif®cult, does not improve the success rate of the IG±IH nerve block compared with the SS technique.
Ağrı, 2022
Inguinal hernia repair is one of the most common daily surgeries performed in pediatrics. This prospective randomized clinical trial aims to compare ultrasound (USG)-guided ilioinguinal/iliohypogastric (IL/IH) nerve block and pre-incisional wound infiltration (PWI) in terms of post-operative analgesia on pediatric unilateral inguinal hernia repair. Methods: After receiving ethics committee approval, 65 children aged 1-6 years who had unilateral inguinal hernia repair were allocated to USG-guided IL/IH nerve block (group IL/IH, n=32) and (group PWI, n=33). In both groups, 0.5 mg/kg 0.25% bupivacaine+2% prilocaine mixture was used by calculating the volume as 0.5 mL/kg for the block and infiltration. The primary outcome was to compare both groups' post-operative Face, Legs, Activity, Cry and Consolability (FLACC) scores. The secondary outcomes included the time to first analgesic request and the total acetaminophen consumption. Results: The FLACC pain scores at the 1 st , 3 rd , 6 th , and 12 th h were statistically significantly lower in group IL/IH than in group PWI (p=0.013, p<0.001, p<0.001, and p=0.037, respectively) (p<0.001). There was no difference between the groups at the 10 th and 30 th min and at 24 h (p=0.472, p=0.586, and p=0.419, respectively) (p>0.05). Conclusion: USG-guided IL/IH nerve block in pediatric patients with inguinal hernia repair was found to be superior to PWI in terms of lower pain scores, less additional analgesia requirement, and longer first analgesia requirement.
Rambam Maimonides Medical Journal, 2016
Abbreviations: BMI, body mass index; BW, body weight; ILI+IHG, ilioinguinal and iliohypogastric nerve block; IV, intravenously; NP scale, nurses' assessment of postoperative pain scale; PACU, postanesthesia care unit; PCA, patientcontrolled analgesia with intravenous morphine; PONV, post-op nausea and vomiting; pre-op, preoperative or preoperatively; post-op, postoperative or postoperatively; PROSPECT, procedure-specific post-op pain management; TAP, posterior transversus abdominis plane block; US, ultrasound. Citation: Stav A, Reytman L, Stav M-Y, Troitsa A, Kirshon M, Alfici R, Dudkiewicz M, Sternberg A. Transversus ABSTRACT Objectives: We hypothesized that preoperative (pre-op) ultrasound (US)-guided posterior transversus abdominis plane block (TAP) and US-guided ilioinguinal and iliohypogastric nerve block (ILI+IHG) will Nerve Blocks for Analgesia Following Open Herniorrhaphy Rambam Maimonides Medical Journal 2 July 2016 Volume 7 Issue 3 e0021
Anaesthesia, 2006
The aim of this study was to compare the efficacy of nerve stimulator guided paravertebral block with ilio-inguinal nerve block in children undergoing inguinal herniorrhaphy. Eighty children were randomly allocated to receive either paravertebral block or ilio-inguinal nerve block. Each block was evaluated in terms of intra-operative haemodynamic stability, postoperative pain scores at rest, on movement and during activity, requirement for supplemental analgesia and parental satisfaction. Haemodynamic stability was maintained significantly better during sac traction in the paravertebral block group (p < 0.005). Pain scores and analgesic consumption were significantly lower in the paravertebral block group during the postoperative follow-up period (p < 0.05). Parental satisfaction (93%vs 69%) and surgeon satisfaction (93%vs 64%) were significantly higher in the paravertebral block group (p < 0.05). Paravertebral blockade improved and prolonged postoperative analgesia, and was associated with greater parental and surgeon satisfaction when compared to ilio-inguinal nerve block.
Introduction: Inguinal hernia repair is usually performed under spinal anaesthesia. However, local anaesthesia technique provides stable hemodynamics with early ambulation and less postoperative pain. We compared efficacy, feasibility and safety of ilioinguinal/iliohypogastric nerve block for inguinal hernia repair with spinal anaesthesia. Material and methods: Sixty adult male patients scheduled for elective inguinal hernia repair were randomized into two groups to receive either ilioinguinal/iliohypogastric nerve block or spinal anaesthesia. The total time to perform anaesthetic procedures, time of onset, hemodynamic variations, supplemental sedation, intraoperative fluid requirement, duration of postoperative analgesia and ambulation were compared in both groups. Continuous data are presented as mean±S.D. Unpaired t-test and paired t-test were applied for intergroup and intragroup comparisons respectively. P <0.05 was taken as significant. Results: Duration to perform ilioinguinal/iliohypogastric nerve block was significantly longer (7.95±0.461 minutes) than that of spinal block (3.73±0.679 minutes). Systolic and mean blood pressure showed statistically significant reduction in first 40 minutes with higher intraoperative fluid requirement in Group II patients (1280±190.1 ml vs 348.33±77.106 ml). Group I patients required higher dose of midazolam (3.00±0.347 vs 2.23±0.254 mg) (p<0.05). Supplemental anaesthetic infiltration was required in 36.7% patients in Group I and 45.45% of them required propofol for sedation (55.56±5.11 mg). The duration of postoperative analgesia was longer in Group I (5.163±0.4542 vs 3.871±0.4801 hours) (p<0.05). Duration of ambulation was significantly shorter in Group I (3.95±2.56 vs 9.58± 0.87 hours) (p<0.05). Conclusion: Ilioinguinal/iliohypogastric nerve block can be a safe alternative to spinal anaesthesia for elective unilateral inguinal hernia repair.
Zanjan University of Medical Sciences, 2019
Background & Objective: Dexamethasone has been emerged as an adjuvant to local anesthetics to provide optimal analgesia. We have evaluated the postoperative analgesic efficacy of adding a low dose dexamethasone to bupivacaine in ilioinguinal and iliohypogastric blocks in patients undergoing inguinal herniorraphy under spinal anesthesia. Materials & Methods: 50 patients in the range of 20 - 80 years of age underwent elective surgery for the purpose of inguinal hernia repair under spinal anesthesia recruited in a prospective, double-blinded, randomized manner. At the end of the surgery, the patients received an ilioinguinal and iliohypogastric block through the direct injection of drugs around nerves. Patients in the control group received bupivacaine 0.5% (2 cc) plus normal saline 1 cc (group C), and the dexamethasone group received bupivacaine 0.5% (2 cc) plus 4 mg (1 cc) dexamethasone (group D). The pain intensity was measured using the VAS scale at1, 2, 4, 12, and 24 hours after surgery. Results: The mean time of analgesic duration in group C (3.6±3.8 hr) was greater than group D (1.6±1.14 hr). This difference was statistically significant (P =0.043). The pain intensity 2 hours after surgery in group D was higher than in group C (median with IQR: 3±4 vs. 2±2; P=0.007). The difference in the total analgesic consumption in group D (51.1±32.4 mg) versus group C (26.4±33.8 mg) was significant (P=0.018). Conclusion: The addition of 4 mg dexamethasone to bupivacaine in an ilioinguinal and iliohypogastric block at the end of surgery in patients undergoing inguinal herniorraphy under spinal anesthesia failed to prolong the time to the first analgesic request. It provides only a minor analgesic effect 12 hours following surgery. Keywords: Dexamethasone, Inguinal herrniorraphy, Ilioinguinal nerve, Iliohypogastric nerve, Pain
Asian Journal of Medical Sciences
Background: Inguinal hernia surgeries are associated with postoperative pain and discomfort. Transversus abdominis plane (TAP) block and Ilioinguinal/Iliohypogastric (IIIH) nerve blocks are widely used to control postoperative pain. In this study we have compared postoperative pain relief between TAP block and IIIH nerve block in the patients undergoing inguinal hernia surgery under spinal anesthesia. Aims and Objectives: The primary aim of this study was to compare postoperative pain relief of TAP block and IIIH block in patients undergoing inguinal hernia surgery. Secondary objectives were to observe hemodynamic parameters and to observe for postoperative side effects if any. Materials and Methods: Sixty patients of age group 18–65-year-old males, ASA grade I, II, were randomised into two groups TAP group (n=30) and IIIH group (n=30). TAP group received 30 mL of 0.25% ropivacaine TAP block and group IIIH received 20 mL, and wound infiltration with 10 mL of 0.25% ropivacaine. Durat...