Effects Of Postoperative Analgesia With Different Concentrations Ropivacaine Used In Iliohypogastric/ilioinguinal Nerve Block In Patients With Cryptorchidism

Objective: To investigate the effectiveness and safety of Iliohypogastric/Ilioinguinal nerve block(IINB)with different concentration of ropivacaine for postoperative analgesia in patients with cryptorchidism.Methods:Sixty-nine children with unilateral testicular fixation,aged 1~6 years,weight 9~24 kg,ASA ? or ?,scheduled for elective unilateral testicular fixation were randomly divided into three groups(n=23): 0.20% ropivacaine group(group A),0.25% ropivacaine group(group B)and 0.30% ropivacaine group(group C).Unilateral testicular fixation was performed under general anesthesia,and ultrasound-guided IINB using different concentrations of ropivacaine 1mg/kg was performed into the affected side at the end of the surgery.MAP,HR,FLACC scores,and Comfort scores at entering PACU(T0),1 h(T1),2 h(T2),4 h(T3),6 h(T4),8 h(T5),and 24 h(T6)after surgery,the users of additional analgesic drugs,and the complications associated with nerve block were recorded.The serum substance P concentrations were measured respectively before operation,after operation,at 6 and24 h after operation.Results : Compared with group A,the FLACC scores were significantly decreased from T2 to T4 in group C and at T3,T4 in group B(P<0.05),the Comfort scores were significantly decreased at T0,T3,and T4 in group C and at T4 in group B(P<0.05);compared with group A,MAP were significantly decreased from T0 to T6 in group B and group C(P<0.05),HR were significantly decreased from T1 to T6 in group C(P<0.05);compared with group B,HR were significantly reduced at T2,T3,and T5 in group C(P<0.05);compared with group A,the serum substance P concentrations were significantly reduced at 6 and 24 hours after surgery in group Band group C(P<0.05);the numbers using additional analgesic drugs were significantly reduced within 24 hours after operation in group C(P<0.05).There were no side effects such as local anesthetic toxicity,hematoma at puncture site and quadriceps femoris hypodynamia in all three groups.Conclusions : 0.25% and 0.30% ropivacaine 1mg/kg can provide safe and effective analgesia in IINB after unilateral testicular fixation,they can be applied in clinical practice.