Comparison of Ultrasoundguided Ilioinguinal Iliohypogastric Nerve Block with Wound Infiltration during Pediatric Herniotomy Surgeries.

Background and Aims: The purpose of this study was to compare the analgesic efficacy of the ilioinguinal-iliohypogastric nerve block (II/IH) with local wound infiltration in children undergoing herniotomy surgeries.

Methods: After ethics committee approval and informed consent, 100 children aged 6 months-7 years posted for herniotomy surgeries were randomly divided into Group B and Group W. Local wound infiltration was performed in Group W by the surgeon at the time of port placement and the end of the surgery with 0.2 mL.kg-1 of 0.25% bupivacaine. Ipsilateral II/IH was performed in Group B at the end of the surgery, under ultrasonographic guidance with a Sonosite portable ultrasound unit and a linear 5-10 MHz probe with a 22G hypodermic needle, and 0.2 mL.kg-1 of 0.25% bupivacaine was used on each side. The parameters recorded were postoperative hemodynamics, paracetamol and opioid requirements, postoperative pain scores, postoperative nausea vomiting, and the need for rescue analgesia in the first 6 h postoperatively.

Results: The median pain scores were significantly lower in the II/IH group than the local wound infiltration group at 10 min (2 [0-2.5] compared to 2 [3-4]; P = 0.011), 30 min (1.5 [0-3] compared to 3 [2-5]; P < 0.001), 1 h (1.5 [0-2] compared to 2 [2-3]; P < 0.001) and 2 h (2 [0-2] compared to 2 [1.5-2.5]; P = 0.010) postoperatively. The need for postoperative opioids and rescue analgesia was also significantly lower in the II/IH group ( P < 0.001).

Conclusion: II/IH is superior to local wound infiltration for postoperative analgesia in pediatric herniotomy surgeries.