Ilioinguinal and iliohypogastric nerve block revisited: single shot versus double shot technique for hernia repair in children.
BACKGROUND
We attempted to determine the efficacy of a one plane ilioinguinal and iliohypogastric nerve block with a single shot and double shot techniques.


METHODS
In a randomized single blind study, 90 children, aged 2-12 years, received a single shot (SS) or a double shot (DS) technique for ilioinguinal and iliohypogastric (IG-IH) nerve block for inguinal hernia repair. In the SS group, 0.25 ml x kg(-1) of 0.25% bupivacaine was given one fingerbreadth medial to the anterior superior iliac spine under the external oblique aponeurosis. In the DS group, one-third of the total dose of bupivacaine was given as for the SS group. The remaining two-thirds was deposited 0.5 cm above and lateral to the mid-inguinal point deep to the external oblique aponeurosis.


RESULTS
The success rates of both techniques were similar, at 72%, although the presence of local anaesthetic in the inguinal canal was significantly higher with the DS technique. The incidence of femoral nerve block was 4.5% with the SS and 9% with the DS technique (P > 0.05). Parental satisfaction with postoperative pain relief was high, at 94%.


CONCLUSIONS
The DS technique, while technically more difficult, does not improve the success rate of the IG-IH nerve block compared with the SS technique.
Lim
Suan-Ling
SL
Department of Paediatric Anaesthesia, KK Women's and Children's Hospital, Singapore, Singapore. limsl@kkh.com.sg
Ng Sb
Agnes
A
Tan
Geok-Mui
GM
D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D009407:Nerve Block / Q000379:methods; D016037:Single-Blind Method
D000779:Anesthetics, Local; D002045:Bupivacaine