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Application of Ultrasound-Guided Ilioinguinal/Iliohypogastric Nerve Block in Pediatric Same-Day Surgery
Lihua Yang1, Yucan Xu1, Zhongyu Wang1
1Department of Anesthesiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhongyuan District, Zhengzhou, 450052 China.
Insights
Ultrasound-guided ilioinguinal/iliohypogastric nerve block (IINB) is a safe and effective anesthesia method for pediatric inguinal surgery. This technique improved postoperative pain control and recovery time compared to traditional methods.
Area of Science:
- Pediatric Anesthesiology
- Regional Anesthesia
- Ultrasound-Guided Procedures
Background:
- Inguinal region surgery in pediatric patients often requires effective anesthesia and postoperative pain management.
- Traditional nerve blocks may have limitations in efficacy and recovery.
- Ultrasound guidance offers potential for improved precision in regional anesthesia.
Purpose of the Study:
- To evaluate the safety and efficacy of ultrasound-guided ilioinguinal/iliohypogastric nerve block (IINB) in pediatric patients undergoing same-day inguinal surgery.
- To compare ultrasound-guided IINB with traditional IINB and intravenous anesthesia.
Main Methods:
- Ninety pediatric patients (4-6 years, ASA I-II) were randomized into three groups: ultrasound-guided IINB (U), traditional IINB (T), or control (C) with intravenous anesthesia.
- Hemodynamic parameters (HR, MAP, SPO2) were monitored throughout the procedure.
- Postoperative pain scores and recovery time were assessed.
Main Results:
- Ultrasound-guided IINB (Group U) required significantly less ketamine and resulted in lower pain scores during awakening compared to traditional IINB (Group T) and control (Group C).
- Hemodynamic parameters were more stable in Groups U and T compared to Group C.
- Group C showed significantly prolonged recovery time.
Conclusions:
- Ultrasound-guided IINB is a safe and effective anesthesia technique for pediatric inguinal surgery.
- It provides superior postoperative analgesia, reduces anesthetic requirements, and facilitates faster recovery.
- This method offers improved outcomes compared to traditional nerve blocks and intravenous anesthesia alone.
Abstract:
The aim of this study was to evaluate the safety and efficacy of ultrasound-guided ilioinguinal/iliohypogastric nerve block (IINB) in pediatric patients undergoing same-day inguinal region surgery. Ninety patients aged 4-6 years, ASA levels I-II, were randomly divided into three groups: U, T, or C (n = 30 each). After basic anesthesia, patients in group U underwent ultrasound-guided IINB, those in group T underwent traditional Schulte-Steinberg IINB, and those in group C (controls) received intravenous anesthesia (ketamine-propofol) only. Patients who remained sensitive to intraoperative stimuli received additional intravenous doses of 1 mg/kg ketamine. Heart rate (HR), mean arterial pressure (MAP), and oxygen saturation (SPO2) were recorded upon entering the operating room (T0), at skin incision (T1), while pulling the hernia sac (T2), during skin closing (T3), and upon awakening (T4) at recovery. HR and MAP at T1, T2, and T4 were higher in group C than those in the other two groups, and recovery time in group C was significantly prolonged (P < 0.05). Group U required significantly lower quantities and frequency of ketamine injection, and pain scores in group U during awakening were lower than those in the other two groups (P < 0.05). Ultrasound-guided IINB provided an improved nerve block effect and postoperative analgesia, reduced the amount of local anesthetic required, facilitated more rapid postoperative recovery, and was a safe and effective method of anesthesia.
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