Publication: Analgesia after inguinal herniotomy in children: Combination of simplified (Single Puncture) ilioinguinal and iliohypogastric nerve blocks and wound infiltration vs. caudal block with 0.25% bupivacaine
Date
2005
Authors
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Journal ISSN
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Publisher
Kathmandu University
Abstract
Objective: To assess whether simplified ilioinguinal and iliohypogastric nerve block in combination with minimal
wound infiltration with local anaesthetic is better than caudal block with local anaesthetic alone in children
undergoing inguinal herniotomy for easy transition to safe oral analgesia. Subject and Methods: Sixty children of
both sexes undergoing herniotomy were allocated randomly to receive either simplified (single puncture)
ilioinguinal and iliohypogastric nerve block described by Dalens in combination with small volume wound
infiltration with 0.1ml/kg of 0.25% bupivacaine (Group I) or caudal block with 1 ml/kg of 0.25% bupivacaine
(Group II) at the end of surgery under general anaesthesia using halothane in oxygen and nitrous oxide mixture.
Duration of analgesia, complication associated, parents and children’s satisfaction were compared. Results: The
mean duration of analgesia was 253±102.6 minutes in group I as compared to 219.6±48.4 minutes in group II. Six
(20%) patients in group I and two (6.67%) patients in group II required parenteral analgesic. Complications and
parents and children’s satisfaction were comparable in both the groups. Conclusion: Simplified ilioinguinal and
iliohypogastric nerve blocks described by Dalens in combination with small volume local anaesthetic wound
infiltration with its longer mean duration of analgesia offers better safety margin to start oral analgesics than caudal
block with local anaesthetic alone in children undergoing herniotomy. Larger studies may further confirm the
findings.
Key words: Simplified ilioinguinal and iliohypogastric nerve blocks, wound infiltration, caudal block