A Comparison between Ilioinguinal and Iliohypogastric Nerve Block and Infiltration of Local Anesthetics for Postoperative Pain after Inguinal Herniorrhaphy in Children

Dae-Geun Park; Nam-Hyuk Lee

doi:10.13029/jkaps.2014.20.1.7

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Park and Lee: A Comparison between Ilioinguinal and Iliohypogastric Nerve Block and Infiltration of Local Anesthetics for Postoperative Pain after Inguinal Herniorrhaphy in Children

Original Article

Journal of the Korean Association of Pediatric Surgeons 2014; 20(1): 7-11.

Published online: 30 June 2014

DOI: https://doi.org/10.13029/jkaps.2014.20.1.7

A Comparison between Ilioinguinal and Iliohypogastric Nerve Block and Infiltration of Local Anesthetics for Postoperative Pain after Inguinal Herniorrhaphy in Children

Dae-Geun Park, Nam-Hyuk Lee

Department of Surgery, Yeungman University Collage of Medicine, Daegu, Korea.

Correspondence: Nam-Hyuk Lee, Department of Surgery, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu 705-703, Korea. Tel: 053-620-3584, Fax: 053-624-1213, nhlee@med.yu.ac.kr

Received 15 March 2014 Accepted 1 June 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.

Keywords: Inguinal hernia, Postoperative pain, Ilioinguinal and iliohypogastric nerve block, Infiltration, Children

Figures and Tables

Table 1

FLACC Pain Assessment Tool

Table 2

Patients and Clinical Data

Table 3

Postoperative Pain Scores

^*p<0.05 vs control group.

Table 4

Requirement of Rescue Analgesics and Complications

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