Application Of Ilioinguinal And Iliohypogastric Nerve Block By Ultrasound-guided In Pediatric Inguinal Surgery

Objective:In ultrasound imagine technology assistance,we can observe the anatomy image visually and position accurately. The use of ultrasonographic guidance can reduce the difficulty of pediatric anaesthesia. To evaluate the efficacy and safty of iliohypogastric and ilioinguinal nerve block by ultrasound-guided in children undergoing inguinal surgery.Methods:Sixty pediatric patients with ASA status I aged7-12years old, scheduled for elective unilateral inguinal surgery were randomly divided into group A and group B.Thirty cases of each. Group A were given iliohypogastric nerve-ilioinguinal nerve block by ultrasound-guided combined with general anesthesia, while Group B were given Total intravenous anesthesia. To observe the patients’s heart rate (HR)、sphygmus oxygen saturation (SpO2)and mean artery pressure(MAP)when they just came into the operation-room(T1), just the beginning operation(T2)and the recovery time (T3); the amount of Ketamine and Propofol;the wake time after operation;the adverse effects,and the time of children in PACUwere recorded. Visual analogue scale score (VAS) was used to assess the pain score postoperatively at recovery time,2and4h postoperation respectively. If the pain score was above or equal to4,the child received Tramadol2mg/kg intravenously. Compared the intelligence of the two grounps on24hours preoperatively with8hours and24hours postoperatively by SPM (Raven’s Standard Progressive Matrices). Results:The HR、MAP of group A were not considerable change at all time points(P>0.05), but the HR,MAP of group B at T2,T3were higher than that at T1(P<0.05). The HR,MAP of group A at T2,T3were lower than that of group B (P<0.05).The adverse effects of group A were less than group B,the differences were statistically significant(P<0.05). There was no statistical significance between the SpO2of two groups at all time points(P>0.05).The amount of Ketamine an Propofol of group A were considerably less than that of group B,and the wake time after operation were shorter than that of group B(P<0.01and P<0.05).The pain score at recovery time,2and4h postoperation in group A was significantly lower than those in group B(P<0.05).The time of children in PACU of grounp A was shorter than grounp B. In grounp B the score of SPM on8hours postoperatively were decreased significantly(P<0.05),but the score of24hours postoperatively have no significant difference;compared with24hours preoperatively,8houurs and24hours postoperatively have no significant difference in grounp A.Conclusion:The efficacy and safty of iliohypogastric and ilioinguinal nerve block under ultrasound guidance in children’s inguinalis surgery is warranted, cognitive function recover rapidly and less complications;it decreases the dosage of general anesthetic drugs,as well as offers a good postoperative analgesia.