Open Access
Subscription Access
Comparative Evaluation of Combined Ilioinguinal Iliohypogastric Block Versus Caudal Block using Ropivacaine and Clonidine for Paediatric Postoperative Analgesia Following Inguinal Hernia Repair
Background: Inguinal hernia repair is a commonly performed surgery in children. Various regional techniques have been used for postoperative analgesia however the duration of analgesia is limited by local anesthetics. Objectives: To compare the postoperative analgesia and complications of combined ilioinguinal iliohypogastric block versus caudal block following inguinal hernia repair surgery in children using 0.2% ropivacaine and clonidine (1 μg/kg). Methods: Forty children of age one month to three years undergoing inguinal hernia repair were randomly allocated to two Group C (receiving Caudal block) and group I (receiving combined ilioinguinal iliohypogastric block). Ropivacaine 0.2% and clonidine1 μg/kg used. Patients were evaluated for pain postoperatively at 30 minutes, 1, 1 ½, 2, 4, 8, 12 and 24 hours. Results: Both techniques were effective for postoperative analgesia following hernia repair in children for 24 hours postoperatively. Conclusion: Both combined Ilioinguinal iliohypogastric and caudal block were effective for postoperative analgesia for 24 hours using ropivacaine 0.2% and clonidine 1 μg/kg following inguinal hernia repair in children and no complications were seen in any of the two blocks.
Keywords
Caudal, Clonidine, Ilioinguinal Iliohypogastric, Paediatric Analgesia, Ropivacaine.
User
Font Size
Information
- Yaster M, Maxwell LG. Paediatric regional anaesthesia. Anaesthesiology. 1989; 70:324-38. https://doi.org/10.1097/00000542-198902000-00024 PMid:2643896
- Schindler M, Swann M, Crawford M. A comparison of postoperative analgesia provided by wound infiltration and caudal analgesia. Anaesth Intensive Care. 1991; 19:46-9. https://doi.org/10.1177/0310057X9101900108 PMid:2012294
- Pediatric Regional Anaesthesia. In: Motoyama E, Davis P, eds. Smith’s anesthesia for infants and children. 7th ed. St. Louis: Mosby; 2005.
- Kay B. Caudal block for post-operative pain relief in children. Anaesthesia. 1974; 29:610-11. https://doi.org/10.1111/j.1365-2044.1974.tb00731.x PMid:4433023
- Markham SJ, Tomlison J, Hain WR. Ilioinguinal nerve block in children. A comparison with caudal block for intra and postoperative analgesia. Anaesthesia. 1986; 41:1098-3. https://doi.org/10.1111/j.1365-2044.1986.tb12956.x PMid:3789367
- Langer JC, Shandling B, Rosenburg M. Intraoperative bupivacaine during outpatient hernia repair in children: a randomized double blind trial. J Pediatr Surg. 1987; 22:267-70. https://doi.org/10.1016/S00223468(87)80344-5
- Casey WF, Rice LJ, Hannallah RS, Broadman L, Norden JM, Guzzetta P. A comparison between bupivacaine instillation versus ilioinguinal/ iliohypogastric nerve block for postoperative analgesia following inguinal herniorrhaphy in children. Anaesthesiology. 1990; 72:637-9. https://doi.org/10.1097/00000542-199004000-00011 PMid:2321781
- Ivani G, Lampugnani E, Torre M, Calevo Maria G, DeNegri P, Borrometi F, et al.. Comparison of ropivacaine with bupivacaine for paediatric caudal block. BJA. 1998; 81:247-248. https://doi.org/10.1093/bja/81.2.247 PMid:9813532
- Knudsen K, Beckmen SM, Blomgberg S, Sjovall J, Edvardsson N. Central nervous and cardiovascular effects of i.v. infusions of ropivacaine, bupivacaine and placebo in volunteers. BJA. 1997; 78:507-14. https://doi.org/10.1093/bja/78.5.507 PMid:9175963
- Tsuchiya N, Ichizawa M, Yoshikawa Y, Shinomura T. Comparison of ropivacaine with bupivacaine and lidocaine for ilioinguinal block after ambulatory hernia repair in children. Pediatric Anesthesia. 2004; 14:468-470. https://doi.org/10.1111/j.1460-9592.2004.01234.x PMid:15153208
- Ivani G, Mereto N, Lampugnani E, Negri PD, Torre M, Mattioli G et al. Ropivacaine in paediatric surgery: Priliminary results. Paediatr Anaesth. 1998; 8:127-9. https://doi.org/10.1046/j.1460-9592.1998.00246.x PMid:9549738
- Bajwa SJS, Kaur J, Bajwa SK, Bakshi G, Singh K, Panda A. Caudal ropivacaine-clonidine: A better post operative analgesic approach. IJA. 2010; 54:226-30. https://doi.org/10.4103/0019-5049.65368 PMid:20885869 PMCid:PMC2933481
- Lee JJ, Rubin AP. Comparison of a bupivacaine clonidine mixture with plain bupivacaine for caudal analgesia in children. Br J Anaesth. 1994; 72:258-262. https://doi.org/10.1093/bja/72.3.258 PMid:8130041
- Negri PD, Ivani G, Visconti C, Vivo PD. How to prolong postoperative analgesia after caudal anaesthesia with ropivacaine in children: S-ketamine versus clonidine. Paediatric Anaesthesia. 2001; 11:679-683. https://doi.org/10.1046/j.1460-9592.2001.00742.x PMid:11696143
- Ivani G, Conio A, Negri PD, Eksborg S, Lonnqvist PA. Spinal versus peripheral effects of adjunct clonidine: comparison of the analgesic effect of a ropivicaine-clonidine mixture when administered as a caudal or ilioinguinal-iliohypogastric nerve blockade for inguinal surgery in children. Pediatric Anaesthesia. 2002; 12:680-84. https://doi.org/10.1046/j.1460-9592.2002.00935.x PMid:12472703
- Dalens B. Regional anesthetic techniques. In Bissonnette DB, editor. Pediatric Anesthesia- Principles and techniques, 1st ed. McGrawHill; 2002. p. 563-5.
- Dijk MV, Peters JWB, Deventer PV, Tibboel D. The COMFORT behavior scale. AJN Jan. 2005; 105:33-6. https://doi.org/10.1097/00000446200501000-00019 PMid:15659992
- Dawkins CJM. An analysis of complications of extradural and caudal block. Anaesthesia. 1969; 24:554-63. https://doi.org/10.1111/j.1365-2044.1969.tb02909.x PMid:4242599
- McNicol LR. A complication of ilioinguinal block for inguinal hernia repair. Anaesthesia1. 988; 43:706. https://doi.org/10.1111/j.1365-2044.1988.tb04170.x
- Johr M, Sossai R. Colonic puncture during ilioinguinal nerve block in a child. Anesth Analg. 1999; 88:1051-2. https://doi.org/10.1097/00000539-199905000-00015 PMid:10320167
- Amory C, Mariscal A, Guyot E. Is ilioinguinal /iliohypogastric nerve block always totally safe in children? Pediatr Anaesth. 2003; 13:164-6. https://doi.org/10.1046/j.1460-9592.2003.01005.x PMid:12562490
Abstract Views: 510
PDF Views: 201