Ultrasound-guided nerve block for pediatric inguinal herniorrhaphy

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.