Comparison Of The Effectiveness Of The Ilioinguinal Iliohypogastric Block And The Transversus Abdominis Plane Block For Analgesia After Unilateral Inguinal Hernia Repair

Author : Yuki Takeda
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (125 download)

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Download or read book The Transversalis Fascia Plane Block And The Ilioinguinal/Iliohypogastric Nerve Block Whereby Ropivacaine Is Placed At The Transverse Abdominis Muscle In Addition To The Correct Plane Are Superior To The Classical Ilioinguinal/Iliohypogastric Nerve Block written by Yuki Takeda and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Goal of Study Ultrasound-guided ilioinguinal/iliohypogastric nerve block (IIB) is widely used in pediatric inguinal herniorraphy. An advocated technique is cross-plane, which has some difficulty. In clinical practice, local anesthetic (LA) is often injected into incorrect plane (not injected between the internal oblique muscle (IO) and transversus abdominis muscle (TA), but into the two muscles themselves). Therefore, we investigated the influence of where LA was placed. Our hypothesis was the injection at IO is effective because the nerves pass through it near the block injection site. Recently, a successful effect of the transversalis fascia plane block (TFPB) for inguinal hernia repair is reported and we have introduced it, hence, we report the comparison with IIB.Materials and Methods: We studied 86 children who underwent the Potts procedure from October 2016 to December 2017. We extracted heart rate (HR) and respiratory rate (RR) before skin incision (SI) and the maximum value (MX) during operation from the electronic anesthesia records. Anesthetic method was standardized; General anesthesia was maintained with 70% of nitrous oxide and 2% sevoflurane in oxygen. Airway was secured by the proseal LMA and spontaneous ventilation with pressure support 10cm H2O was applied. Ultrasound -guided IIB and TFPB were performed using a linear probe. The goal of IIB was 0.1 ml/kg of 0.2% ropivacaine injection between IO and TA. We made three groups by the placement of LA. IO group: more than 0.05 ml/kg of LA was injected in IO. TA group: more than 0.05 ml/kg of LA was injected in TA. Correct group: most of LA was injected between IO and TA. TFPB group received 0.4 ml/kg of LA.Results and Discussion: The HR before SI and the MX in each group were the following: the correct group; 104u00b115 and 134u00b115, the IO group; 107u00b114 and 140u00b114, the TA group; 103u00b116 and 120u00b119, TFPB group; 99u00b114 and 120u00b116. The MXs in the TA and TFPB group were significantly lower. The RR before SI and the MX in each group were the following: the correct group; 31u00b17 and 49u00b111, the IO group; 30u00b13 and 46u00b110, the TA group; 30u00b16 and 41u00b110, the TFPB group; 33u00b17 and 44u00b110. The MX in the TA group was significantly lower compared to the correct and the IO groups.Conclusion(s): The IIB whereby LA was placed at TA in addition to the correct plane attenuated intraoperative HR and RR increases. The TFPB may be an alternative to the IIB, but we need more data and experience.