Ilioinguinal nerve block in children

Abstract

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

A Systematic Review and Meta-Analysis of Caudal Block as Compared to Noncaudal Regional Techniques for Inguinal Surgeries in Children

“…Higher incidence of MB and UR was seen particularly with two studies. Markham and colleagues observed 12/26 (CB) versus 6/26 (INB) children, found not walking at 6 hrs [10]. They also had a higher incidence of UR with 12/26 (CB) versus 5/26 (INB), having not voided at 6 hrs.…”

A Review of the Quadratus Lumborum Block and ERAS

“…The truncal nerve blocks, as a part of perioperative pain management, were introduced into clinical practice over 40 years ago. Primarily these were the ilioinguinal–iliohypogastric (II–IH) block ( 1 – 4 ) and the rectus sheath block ( 5 ), mostly used in the pediatric anesthesia population. In the early years of the 21st century, the transversus abdominis plane (TAP) block was introduced in everyday practice, providing a much wider field of analgesia ( 6 , 7 ).…”

Comparison of 3 different regional block techniques in pediatric patients

“…A few studies have reported that caudal blocks and II/IH nerve blocks performed after general anesthesia are effective in postoperative pain control in children undergoing orchiopexy or herniorrhaphy, and no significant difference has been reported between these 2 techniques. 5 , 6 However, the doses used in those studies were different; they used 0.25% bupivacaine at a dose of 2.5 ml/kg in the caudal block group and 4-6 ml in the II/IH group. In these studies, a higher dose than suggested for II/IH blocks was used and lower doses were used for caudal blocks.…”