Effect of ilioinguinal nerve block on the catecholamine plasma levels in orchidopexy: comparison with caudal epidural block.
BACKGROUND
Both caudal epidural and ilioinguinal/iliohypogastric nerve blocks have been used to provide effective intra- and postoperative analgesia. Stress response hormone levels can be used as an objective method to assess the analgesic efficacy of the anaesthetic techniques used in infraumbilical surgery in children. In this study, we compared catecholamine blood levels in children undergoing these two different supplementary analgesic/anaesthetic techniques.


METHODS
Thirty male paediatric patients undergoing orchidopexy, ASA I, received inhalation general anaesthesia, and were randomly allocated to one of two groups: a caudal group (n = 15) and an ilioinguinal/iliohypogastric nerve block group (n = 15). Plasma epinephrine and norepinephrine concentrations were measured at the induction time, at the end of surgery, and in the postanaesthesia care unit. Postoperative pain score was also assessed in the postanaesthesia care unit.


RESULTS
In both groups, there was a substantial decrease in the catecholamine blood levels; however, there were significantly higher levels of epinephrine in the ilioinguinal group at the end of surgery (P = 0.008) and in the recovery room (P = 0.02) and a significant higher level of norpinephrine in the recovery room (P = 0.008).


CONCLUSIONS
The result of this study revealed that caudal epidural block was more effective than ilioinguinal block in suppressing the stress response as reflected in epinephrine and norepinephrine blood levels in orchidopexy patients.
Somri
Mostafa
M
Department of Anaesthesiology, B'nai Zion Medical Center, Haifa, Israel. somri_m@yahoo.com
Gaitini
Luis A
LA
Vaida
Sonia J
SJ
Yanovski
Boris
B
Sabo
Edmond
E
Levy
Nurit
N
Greenberg
Avital
A
Liscinsky
Sofia
S
Zinder
Oren
O
D000763:Anesthesia, Caudal; D000769:Anesthesia, Inhalation; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D004837:Epinephrine / Q000097:blood*; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000379:methods*; D009638:Norepinephrine / Q000097:blood*; D010149:Postoperative Pain / Q000517:prevention & control
D009638:Norepinephrine; D004837:Epinephrine