Evaluation of genitofemoral nerve block, in addition to ilioinguinal and iliohypogastric nerve block, during inguinal hernia repair in children.
BACKGROUND
Ilioinguinal and iliohypogastric (IG-IH) nerve block has been widely used in children undergoing inguinal hernia repair. This technique may provide insufficient analgesia for intraoperative management as the inguinal region may receive sensory innervation from genitofemoral nerve. We proposed that addition of a genitofemoral nerve block might improve the quality of analgesia.


METHODS
Ninety-eight children undergoing inguinal hernia repair were assigned randomly to receive either IG-IH nerve block (Group I) or IG-IH and genitofemoral nerve blocks (Group II). Systolic arterial pressure (SAP) and heart rate (HR) were recorded before surgery (control), after skin incision, at sac traction and at the end of surgery. Postoperative analgesic requirements and incidence of complications were recorded until discharge.


RESULTS
At sac traction, SAP and HR were significantly higher in Group I (P<0.05), and the incidence of episodes of increased HR was also significantly higher in Group II (29 vs 12%, respectively, P<0.05). There were no significant differences in SAP and HR at other time points, postoperative analgesic requirements or incidence of complications between the groups.


CONCLUSIONS
The benefit of the additional genitofemoral nerve block to IG-IH nerve block was limited only to the time of sac traction without any postoperative effect. This suggests there is little clinical benefit in the addition of a genitofemoral nerve block.
Sasaoka
N
N
Department of Anesthesiology, Nara Medical University, Nara, Japan. ne6n-ssok@asahi-net.or.jp
Kawaguchi
M
M
Yoshitani
K
K
Kato
H
H
Suzuki
A
A
Furuya
H
H
D000700:Analgesics / Q000008:administration & dosage; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007223:Infant; D007264:Inguinal Canal / Q000294:innervation; D007432:Intraoperative Period; D008297:Male; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies
D000700:Analgesics