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Randomized Comparative Study of Analgesic Effects of Ilioinguinal and Iliohypogastric Nerve Block with Levobupivacaine (0.25%) versus Diclofenac Suppository in Pediatric Patients Undergoing Inguinal Herniotomy under General Anesthesia.
- Source :
- Indian Journal of Pain; 2023 Supplement, Vol. 37, pS35-S40, 6p
- Publication Year :
- 2023
-
Abstract
- Context: Pain management intraoperatively and postoperatively in the pediatric age group is a matter of concern. On the one hand, children are poorer at precisely conveying the extent of pain all the while being more susceptible to pain-related complications such as laryngospasm. On the other hand, children are less suited to use of potent opioids due to associated complications which can often lead to catastrophe. Therefore, a multimodal approach is desirable to optimize pain management in children. A nerve block is a highly effective and popular modality nowadays. In this single-blinded, parallel group, monocentric, and randomized protocol study, we have compared the efficacy of pain control achieved in the use of nonsteroidal anti-inflammatory drugs as analgesic versus iliohypogastric ilioinguinal (IIIH) nerve block in herniotomy in pediatric age group. Materials and Method: The parallel-group prospective study recruited 104 participants who were randomly allocated into two groups of 52 each, such that both groups received 1 mcg/kg fentanyl and sevoflurane during induction of GA. For analgesia, Group 2 was given diclofenac suppository intraoperative after induction of GA. Group 1 was given IIIH nerve block under nerve stimulator guidance for perioperative analgesia. Both groups were studied for the following parameters which included: time to get the 1st dose of rescue analgesic, total dose of rescue analgesic, visual analog scale (VAS) score, and hemodynamic parameters. Results: We observed that Group 1 showed a statistically significant difference in the form of longer duration of analgesia after surgery (9.67 ± 1.80 h vs. 6.35 ± 0.84 h) and lower total dose of rescue analgesic requirement (69.23 ± 2 [22.77] vs. 106.23 ± 2 [21.49]) while having a better hemodynamic profile and lower cumulative VAS score (7.71 ± 1.39 vs. 12.04 ± 1.72). Conclusion: Based on the above findings, we deduce that preincisional nerve stimulator-guided IIIH block by levobupivacaine (0.25%, 0.3 ml/kg) and rectal diclofenac (2 mg/kg) is both safe approaches to provide postoperative analgesia in pediatric inguinal herniotomy under general anesthesia. However, nerve stimulator-guided IIIH nerve block by levobupivacaine is a safe and better choice as it provides more intense analgesia for a longer duration compared to diclofenac suppository in the immediate postoperative period. [ABSTRACT FROM AUTHOR]
- Subjects :
- NONSTEROIDAL anti-inflammatory agents
SEVOFLURANE
T-test (Statistics)
STATISTICAL sampling
FISHER exact test
TREATMENT effectiveness
RANDOMIZED controlled trials
DESCRIPTIVE statistics
MANN Whitney U Test
PEDIATRICS
DICLOFENAC
LONGITUDINAL method
PAIN management
INGUINAL hernia
GENERAL anesthesia
COMPARATIVE studies
NERVE block
BUPIVACAINE
FENTANYL
Subjects
Details
- Language :
- English
- ISSN :
- 09705333
- Volume :
- 37
- Database :
- Complementary Index
- Journal :
- Indian Journal of Pain
- Publication Type :
- Academic Journal
- Accession number :
- 177471206
- Full Text :
- https://doi.org/10.4103/ijpn.ijpn_105_22