Ultrasound-guided nerve block for pediatric inguinal herniorrhaphy

Abstract

ABSTRACT Background and aim Regional anesthesia is one of the best options anesthetic technique, it was very difficult to be used in pediatrics anesthesia, now a days it becomes more easier and safer with the era of high-quality ultrasound. This study aimed to assess the effectiveness of ultrasound-guided nerve block (ilioinguinal/iliohypogastric; II/IH) in pediatric unilateral inguinal herniorraphy, time for first analgesic dose, parents, surgeon satisfaction and complication. Patients and methods The study was done in Zagazig university hospital after approval of the ethical committee. Induction of anesthesia using sevoflorane MAC (Minimal Alveolar Concentration) 4%-6% then Laryngeal Mask Airway was inserted (LMA). Ultrasound-guided (ilioinguinal/iliohypogastric) nerve block was performed on 20 male pediatric patients their age ranged from 4 to 10 years old with ASA status I and II, with unilateral inguinal hernia.hemodynamics as heart rate (HR) blood pressure systolic/diastolic (SBP/DBP) was reported also Children Infants Postoperative Pain (CHIPPS) score was recorded every 2 h until 12 h and time for first analgesic dose also reported. Results Our result showed no significant changes in heart rate (HR) and blood pressure (BP) at skin incision; HR (95 ± 8), BP (97.6±/50 ± 5) and intraoperative HR (93.5 ± 6), BP (99.6 ± 9/51 ± 4) compared with the basal readings; HR (113 ± 10), BP (104 ± 12/53 ± 6). Pain score was evaluated using (ChIPPS), it started to increase after 4 to 5 h and reported by first analgesic dose (5.2 ± 1.5) that managed by paracetamol (15 mg/kg/day). Surgeon and parents were satisfied. Early ambulation and less hospital stay. Less complications (no motor block or urine retention). Conclusion Ultrasound-guided (ilioinguinal and iliohypogastric) nerve block was found to be an ideal intraoperative anesthetic and postoperative analgesic for unilateral inguinal herniorrhaphy in children with no complications.