SummaryFifty-two boys undergoing herniotomy, orchidopexy or ligation of patent processus vaginalis under general anaesthesia had supplementary analgesia; 26 had a caudal epidural block and 26 an ilioinguinal block. Analgesia was assessed both during and afer surgery. Ilioinguinal block provides a useful alternative to caudal block.
Key wordsPain; postoperative. Anaesthetic techniques; caudal, ilioinguinal.There is a continuing search for satisfactory methods of pain relief after surgery. Techniques need to be safe, with a low incidence of side effects, reliably effective and to produce analgesia of adequate duration. It is also advantageous if the technique is simple and without later complications.Caudal block using bupivacaine administered after induction of general anaesthesia but prior to surgery is widely used to provide analgesia during and after operation for lower limb surgery, circumcision and groin surgery in children. However, there is a risk of side effects with this technique,' such as motor block, bladder hesitancy and postural hypotension. Ilioinguinal block, for the relief of post herniotomy pain in children, has been advocated by both Shandling and Steward2 and Smith and Jones.3 A blind, prospective study was undertaken to compare the quality of analgesia both during and after operation provided by these techniques. The incidence of side effects was also recorded.
MethodsFifty-two fit boys (ASA 1) aged between 1 and 12 years due to undergo herniotomy, orchidopexy or ligation of patent processus vaginalis, were admitted to the study. The patients were age matched and randomly assigned to one of two groups, A or B. Group A patients were to have a caudal block and group B an ilioinguinal block. All patients were seen pre-operatively by the anaesthetist. Premedication consisted of oral diazepam 0.5 mg/kg to a maximum of 20 mg. The mood of each child was S
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