Comparison of postoperative analgesia of ultrasound-guided ilioinguinal/iliohypogastric nerve block versus ultrasound-guided TAP block for pediatric inguinal hernia repair

Mohamed, Mahmoud H.; Kamal, Manal Mohamed

doi:10.4103/1687-7934.172763

Cited by 7 publications

(7 citation statements)

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“…One more factor that favoured the successful IIN/IHN block was the easier spread of local anaesthetic in to the deep inguinal ring and blocking the genital branch of genitofemoral nerve. 13 Patients were assessed for occurrence of hypotension, bradycardia, nausea, and vomiting and urinary retention. No statistically significant difference was noted.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy of Ilioinguinal / Iliohypogastric Nerve Block and Transversus Abdominis Plane Block for Postoperative Pain Management in Patients Undergoing Open Inguinal Hernia Repair: A Retrospective Cohort Study

Sundaram¹,

Abzalon²,

Balakrishnan³

2019

jebmh

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BACKGROUNDPostoperative pain in inguinal hernia repair is moderate to severe and is associated with chronic postoperative pain. Ilioinguinal, Iliohypogastric (IIN/IHN) block or Transversus Abdominis Plane (TAP) Block can be used to treat this pain. Recent evidences suggested that ultrasound-guided IIIH block is more effective than TAP block. This retrospective study compared the postoperative analgesia among the ultrasound-guided IIN/IHN block and USG guided TAP block for inguinal hernia repair surgery in adults. We wanted to compare mean duration of requirement of rescue analgesia and postoperative pain scores in patients receiving USG guided Tap block vs ilioinguinal/iliohypogastric block. METHODSAll charts of men 18 years above and up to 60 years, with ASA grade of 1-3, who underwent elective inguinal hernia surgeries under spinal anaesthesia, where included in the study. 60 patients were identified and assigned into two group. Group 1 Patients received TAP block and the group 2 Patients received the ilioinguinal and iliohypogastric nerve block. All cases received subarachnoid block with 0.5% bupivacaine without any adjuvants as the primary mode of anaesthesia. Perioperative data of the subjected patients were collected retrospectively including age, height, weight, ASA classification, hemodynamic parameters, VAS pain scores and the time for rescue analgesia. RESULTSThe mean duration (in minutes) to require rescue analgesia was found to be 320.6 ± 114.2 (min) in group 1 and 410 ± 116.24 (min) in group 2. On comparison of these two values the difference in mean time to rescue analgesic requirement was statistically significant (p<0.005). CONCLUSIONSFollowing inguinal hernia repair surgery, IIN/IHN block provides more effective postoperative analgesia than TAP block.

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Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy of Ilioinguinal / Iliohypogastric Nerve Block and Transversus Abdominis Plane Block for Postoperative Pain Management in Patients Undergoing Open Inguinal Hernia Repair: A Retrospective Cohort Study

Sundaram¹,

Abzalon²,

Balakrishnan³

2019

jebmh

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“…For postoperative pain control in children, regional analgesia is preferred more often because it is easier to apply and does not require additional equipment and care tients, but the results are contradictory (9,(13)(14)(15)(16). While the TAP block is associated with longer analgesia time, lower pain scores, and less analgesic need in some studies (13)(14)(15), it is argued in some studies that II/IH block is preffered in the postoperative period (9,16,17).…”

Section: Discussionmentioning

confidence: 99%

“…While the TAP block is associated with longer analgesia time, lower pain scores, and less analgesic need in some studies (13)(14)(15), it is argued in some studies that II/IH block is preffered in the postoperative period (9,16,17). In the meta-analysis of Wang et al (18) in 2016, it was emphasized that ultrasoundguided II/IH nerve or TAP blocks reduce the need for analgesia during surgery and reduce the pain scores significantly.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-Guided Transversus Abdominis Plane Block Versus Ilioinguinal/Iliohypogastric Block in Intraoperative Anesthesia and Analgesia in Pediatric Patients: A Randomized Controlled Study

Küpeli

Salcan

2018

Iran Red Crescent Med J

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Background: Regional techniques both reduce opioid requirements and provide quality pain control in patients, especially in pediatrics. Objectives: The aim of this study was to compare the contributions of ilioinguinal/iliohypogastric (II/IH) block and transversus abdominis plane (TAP) block combined with sedation to intraoperative anesthesia and analgesia in pediatric surgery. Methods: In this randomized controlled study, 100 patients aged 2 -6 years were enrolled and divided into five groups: TAP block with ketamine; II/IH block with ketamine; TAP block with sevoflurane; II/IH block with sevoflurane; and the control group with sevoflurane alone. Hemodynamics (mean arterial pressure (MAP) and heart rate (HR)), depth of anesthesia, sevoflurane usage, pain score, number of children who needed analgesia, and the time to start rescue analgesia of all patients were recorded. Results: There was nosignificant difference between the study groups, in HR and MAP during operations (P > 0.05). The amount of sevoflurane used in the group supported with both blocks decreased significantly compared to the control group (P < 0.001). In the groups where the block was added until the 6th hour in the postoperative period, there were lower HR and MAP (P < 0.05). Pain scores were high in the first six hours in the control group (P < 0.05). There was a longer duration of analgesia in the ketamine + TAP group and in the Ketamine + II/IH block group (P < 0.001) in comparison to others. A higher analgesic need was found in the control group (P < 0.05). Conclusions: This study revealed that transversus abdominis plane or ilioinguinal/iliohypogastric regional blocks could have same intraoperative/ postoperative effects regarding hemodynamics and intraoperative analgesia in lower abdominal pediatric surgery. Anesthesia can be maintained using sedative medicines only.

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“…2018; 28(3):e65146. In all anesthesia methods, to which II/IH was added, (general anesthesia/regional anesthesia/sedation), better and effective postoperative analgesia, lower pain scores and longer painlessness period were observed in the group to which the block was applied (6,(11)(12)(13)(14). Parallel to the literature, in the present study, the longest analgesia duration was observed in the ketamine-supported II/IH block group and this period was determined as 6.1 ± 3.5 hours.…”

Section: Discussionmentioning

confidence: 99%

Contribution of Ultrasound-Guided Ilioinguinal/Iliohypogastric Block To Intraoperative Anesthesia In Children - Randomized Controlled Study

Küpeli

Biçer

2018

Iran J Pediatr

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Objectives: The aim of this study was to investigate the effect of ilioinguinal/iliohypogastric nerve block (II/IH) only supported by ketamine sedation on intraoperative anesthesia and analgesia. Methods: A total of 60 patients aged between 2 and 6 years, were included in the study. The patients were divided into three groups: 1) the II/IH block and ketamine group, 2) the II/IH block by inserting the laryngeal mask (LMA) and sevoflurane group, and 3) the LMA and sevoflurane group. Peroperative heart rate (HR), mean arterial pressure (MAP), amount of sevoflurane used, postoperative pain scores, number of children needing rescue analgesia, and time required for the first analgesia were recorded. Results:The patients, consisting of 34 males and 26 females had an average age of 4 ± 1.3 years. There was no difference in terms of HR and MAP between the ketamine + block applied group and LMA + block applied group; however, HRs were higher and MAPs were lower in the group in which no block was added but only sevoflurane maintenance was provided and the amount of sevoflurane used significantly decreased in the group supported by (II/IH) block (P < 005). In the postoperative period, the HR, MAP and pain scores were higher in the group with no added block but this difference was significant in the first 6 hours (P < 0.05). Rescue analgesia was applied to a fewer of patients in the groups with added blocks and nausea-vomiting occurred only in the group without block. It was observed that analgesia was needed in average for 6.1 hours in the block group to which ketamine was applied; 4.7 hours in average in the block group to which LMA was applied; and for 2.1 hours in average in the group not supported by block (P < 0.05). Conclusion: In this study, it was determined that II/IH block added to general anesthesia or sedation in pediatric lower abdominal surgery reduced the need for intraoperative anesthesia, provided a more stable intraoperative hemodynamics and analgesia, and provided less pain scores, longer analgesia duration, and shorter analgesia need in the postoperative period.

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Comparison of postoperative analgesia of ultrasound-guided ilioinguinal/iliohypogastric nerve block versus ultrasound-guided TAP block for pediatric inguinal hernia repair

Cited by 7 publications

References 0 publications

Comparison of Efficacy of Ilioinguinal / Iliohypogastric Nerve Block and Transversus Abdominis Plane Block for Postoperative Pain Management in Patients Undergoing Open Inguinal Hernia Repair: A Retrospective Cohort Study

Comparison of Efficacy of Ilioinguinal / Iliohypogastric Nerve Block and Transversus Abdominis Plane Block for Postoperative Pain Management in Patients Undergoing Open Inguinal Hernia Repair: A Retrospective Cohort Study

Ultrasound-Guided Transversus Abdominis Plane Block Versus Ilioinguinal/Iliohypogastric Block in Intraoperative Anesthesia and Analgesia in Pediatric Patients: A Randomized Controlled Study

Contribution of Ultrasound-Guided Ilioinguinal/Iliohypogastric Block To Intraoperative Anesthesia In Children - Randomized Controlled Study

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