Three concentrations of levobupivacaine for ilioinguinal/iliohypogastric nerve block in ambulatory pediatric surgery.
OBJECTIVE
To compare the postoperative analgesia of three different concentrations of levobupivacaine for ilioinguinal/iliohypogastric (II/IH) block in children undergoing inguinal hernia repair.


METHODS
Double-blind, prospective, randomized, controlled trial.


METHODS
Operating room and postoperative recovery area of a university hospital.


METHODS
73 ASA physical status I and II children, aged one to 6 years, scheduled for outpatient inguinal hernia repair.


METHODS
Patients were randomized to receive one of three levobupivacaine concentrations: 0.125% (L0.125), 0.25% (L0.25), or 0.375% (L0.375). All patients received standard anesthesia with sevoflurane and II/IH nerve block.


METHODS
Heart rate (HR), non invasive blood pressure (NIBP), respiratory rate, end-tidal carbon dioxide concentration (ETCO(2)), and oxygen saturation via pulse oximetry (SpO(2)) were monitored during surgery. Postoperative pain scores with CHEOPS (Children's Hospital of Eastern Ontario Pain Scale) and need for rescue analgesia postoperatively were measured and recorded.


RESULTS
60 patients entered the postoperative observational period. The number of patients who received rescue analgesia was comparable in the three groups. In Group L0.125, mean CHEOPS score was significantly higher, and time to first administration of rescue analgesia was shorter, than in the other two groups (P < 0.05). Pain scores and time to first administration of rescue analgesia were comparable between Groups L0.25 and L0.375.


CONCLUSIONS
II/IH nerve block using 0.4 mL kg(-1) of 0.25% levobupivacaine provided satisfactory postoperative pain relief after inguinal herniorraphy.
Disma
Nicola
N
Department of Anesthesia, Gaslini Children's Hospital, 16147 Genoa, Italy. nicoladisma@tin.it
Tuo
Pietro
P
Pellegrino
Sarah
S
Astuto
Marinella
M
D000556:Ambulatory Surgical Procedures / Q000379:methods; D018685:Anesthetics, Inhalation / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D000077554:Levobupivacaine; D008297:Male; D008738:Methyl Ethers / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D000779:Anesthetics, Local; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077554:Levobupivacaine; D002045:Bupivacaine