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Zagazig University Medical Journal

Abstract

BackgroundInguinal hernia is a common pediatric condition ,found nearly in 2% of infant males. One of the commonly used blocks in pediatrics is Ilioinguinal/Iliohypogastric (II/IH) nerve blockade which has been shown to be equally effective compared with caudal blockade for inguinal herniotomy. This study aimed to assess whether ultrasound-guided ilioinguinal/ iliohypogastric nerve blocks with local anesthetic would provide comparable intraoperative and postoperative analgesia to blind technique caudal block with local anesthetic in pediatric unilateral inguinal herniotomy.Patients and methodsWe performed a blind prospective randomized clinical trial on 122 pediatric male patients with unilateral inguinal hernia ,ASA (I,II) ,aged 2 to 7 years old and divided them into 2 groups :group I received ultrasound guided ilioinguinal /iliohypogastric nerve block and group II received blind caudal block .we assessed hemodynamics ,pain score(ChIPPS) ,first call for analgesia and complications .ResultsWe found a statistically significant lower heart rate and systolic blood pressure in group I (II/IH group) than group II (caudal group). There was statistically significant lower pain score at four hours and at six hours postoperatively in group I compared with group II. In group I, less systemic analgesics were needed within 12 hours. Group I showed no motor block and no urine retention compared to group II . ConclusionUltrasound-guided ilioinguinal and iliohypogastric nerve block was found to be an ideal intraoperative and postoperative analgesic for unilateral inguinal herniotomy in children.Keywords: pediatric inguinal herniotomy, regional, ilioinguinal/ iliohypogastric block, caudal block

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