Northern Journal of ISA

Sadhana Sapra Saini ¹, Kirti Nath Saxena ², Bharti Taneja ², Shikha Bansal ³

Affiliations
1 Department of Anaesthesiology, Princess of Wales Hospital, Bridgend, GB
2 Department of Anaesthesiology, Maulana Azad Medical College and Associated Hospitals University of Delhi, IN
3 Department of Anaesthesiology, BLK Superspeciality Hospital, New Delhi, IN

Abstract

Background and Aims: To compare and evaluate the efficacy of Single Level Paravertebral Block (SLPVB) with Caudal Block (CB) using 0.2% ropivacaine. Materials and Methods: A prospective study was performed for 40 children aged 2-8 years, undergoing paediatric inguinal hernia repair. They were divided into 2 groups, of 20 patients each, and SLPVB or CB was administered. They were followed up for 24hours and assessed for efficacy of the block in terms of duration of analgesia and quality of block as assessed by FLACC score. The amount of rescue analgesia used, parent satisfaction, and complications if any were also noted. The data collected was analyzed using SPSS software version 17 and a P value of <0.05 was considered significant and appropriate tests were applied. Results: The mean duration of action was found to be 1001.25±564.34 minutes (Median 1440 and IQR 975 minutes) in CB and 1440 minutes (Median 1440 IQR 0) in the PVB. This was statistically significant (P value = 0.03). The efficacy of the block as assessed by the FLACC score was comparable in the two groups. Rescue analgesia was required in 8 patients in the CB as compared to none in the PVB. The parent satisfaction levels were also significantly higher with PVB as compared to CB. No complications were noted with PVB. Failure of block occurred in 1 patient with CB, and there was complaint of urinary retention in 3 patients in the same group. Conclusion: SLPVB has been demonstrated to be superior to CB to provide postoperative analgesia children undergoing inguinal hernia surgery.

Keywords

Analgesia, Caudal, Inguinal, Lumbar, Paravertebral, Ropivacaine.

Full Text

   

Sadhana Saini Sapra ¹, Kirti Nath Saxena ¹, Bharti Taneja ¹, Shikha Bansal ¹, Yogesh Kumar Sarin ²

Affiliations
1 Department of Anaesthesiology and Intensive Care, Maulana Azad Medical College and Associated Hospitals, New Delhi – 110002, Delhi, IN
2 Department of Paediatric Surgery, Maulana Azad Medical College and Associated Hospitals, New Delhi – 110002, Delhi, IN

Abstract

Background: Inguinal hernia repair is a commonly performed surgery in children. Various regional techniques have been used for postoperative analgesia however the duration of analgesia is limited by local anesthetics. Objectives: To compare the postoperative analgesia and complications of combined ilioinguinal iliohypogastric block versus caudal block following inguinal hernia repair surgery in children using 0.2% ropivacaine and clonidine (1 μg/kg). Methods: Forty children of age one month to three years undergoing inguinal hernia repair were randomly allocated to two Group C (receiving Caudal block) and group I (receiving combined ilioinguinal iliohypogastric block). Ropivacaine 0.2% and clonidine1 μg/kg used. Patients were evaluated for pain postoperatively at 30 minutes, 1, 1 ½, 2, 4, 8, 12 and 24 hours. Results: Both techniques were effective for postoperative analgesia following hernia repair in children for 24 hours postoperatively. Conclusion: Both combined Ilioinguinal iliohypogastric and caudal block were effective for postoperative analgesia for 24 hours using ropivacaine 0.2% and clonidine 1 μg/kg following inguinal hernia repair in children and no complications were seen in any of the two blocks.

Keywords

Caudal, Clonidine, Ilioinguinal Iliohypogastric, Paediatric Analgesia, Ropivacaine.

Full Text

 Untitled