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Evaluation of Caudal Block and Ilioinguinal/Iliohypogastric Nerve Block Efficacy With Perfusion Index in Pediatric

Aycan Kurtarangi̇l Doğan1, Canan Yılmaz2, Derya Karasu2

  • 1Department of Anesthesiology and Reanimation, University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey; Department of Anesthesiology and Reanimation, Kütahya City Hospital, Kütahya, Turkey.

Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses
|July 16, 2026
PubMed

Insights

Caudal and ilioinguinal/iliohypogastric nerve blocks significantly improved pain management in pediatric inguinal hernia repair. These blocks reduced the need for opioids and shortened hospital discharge times, demonstrating their effectiveness.

Area of Science:

  • Anesthesiology and Pain Management
  • Pediatric Surgery
  • Regional Anesthesia Techniques

Background:

  • Effective pain management is crucial for pediatric surgical recovery.
  • Assessing intraoperative analgesia efficacy in children presents unique challenges.
  • Perfusion index (PI) and pleth variability index (PVI) offer potential non-invasive methods for monitoring analgesia.

Purpose of the Study:

  • To evaluate the analgesic efficacy of caudal and ilioinguinal/iliohypogastric (II/IH) nerve blocks in pediatric patients undergoing inguinal hernia repair.
  • To assess the utility of perfusion index (PI) and pleth variability index (PVI) in monitoring intraoperative analgesia success.
  • To compare the outcomes of caudal and II/IH blocks with a control group receiving standard care.

Main Methods:

  • A prospective, randomized, double-blind, controlled trial involving 96 children (2-8 years) undergoing unilateral inguinal hernia repair.
  • Participants were randomized into three groups: control, caudal block, or II/IH block.
  • Analgesia success was defined by a ≥100% increase in PI at incision; outcomes included PI/PVI, hemodynamics, rescue analgesia, FLACC scores, and discharge time.

Main Results:

  • Both caudal and II/IH blocks demonstrated significantly higher successful analgesia rates compared to the control group.
  • PI values were significantly lower in the control group post-incision compared to the block groups.
  • The control group required more intraoperative and postoperative opioids, had higher FLACC scores, and longer discharge times.

Conclusions:

  • Caudal and II/IH nerve blocks are effective in reducing postoperative pain, analgesic requirements, and discharge times in pediatric inguinal hernia surgery.
  • Perfusion index (PI) is a valuable tool for assessing intraoperative analgesia efficacy in pediatric patients.
  • Further research with larger sample sizes and diverse age groups is recommended to confirm these findings.
Abstract

Keywords:
caudal anesthesiainguinal herniapain managementpediatric anesthesiaperfusion indexregional anesthesia

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