Paediatric Analgesia during Inguino-Scrotal Surgery- A Pilot Study
Journal Title: Global Journal of Anesthesiology - Year 2016, Vol 3, Issue 1
Abstract
Introduction: There are many different analgesic methods used for children undergoing inguino-scrotal surgery. Research suggests that caudal analgesia reduces the need for postoperative pain relief in these children compared with regional techniques but may increase the risk of motor block and urinary retention. This can be problematic given that these procedures are commonly performed as day cases. Primary Aim: Assess post-operative pain requirements of the three different analgesic methods used at Medway Maritime hospital in paediatric surgery patients undergoing inguino-scrotal surgery. Secondary Aim: Assess whether there were any differences between these methods in rates of post-operative complications, including time before spontaneous leg movement, micturition, rates of nausea and vomiting and time to discharge. Methodology: This study prospectively recruited paediatric surgery patients undergoing elective day case inguino-scrotal surgery at MMH between May and July 2015. Three analgesic methods were employed: Group 1.IG/IH under ultrasound guidance (10mls, 0.25% levobupivicaine) + direct intra-operative GF block (2mls, 0.25% levobupivicaine) Group 2.Caudal (1.5ml/kg, 0.125% levobupivicaine) + clonidine (1.5mcg/kg) Group 3.Local infiltration (2mg/kg, 0.5% levobupivicaine) with intra-operative morphine (100 micrograms/kg). Results: 26 patients (24 boys, 2 girls) were recruited over a time period of two and a half months. Only one patient from group 1 and one patient from group 2 had positive pain scores, whereas five patients in group 3 had positive pain scores. There was no clinically significant difference in time before first leg movement or micturition between the three groups. Conclusion: Our pilot study suggests that a direct intra-operative block of the GF nerve with a pre-operative IG/IH nerve block provides the same level of postoperative analgesia as a caudal block but without increasing post-operative complications.
Authors and Affiliations
Stern Brendan, Shah Manisha, Veerappan Kumarvel, Chan Shirley
Keywords
Related Articles
- EP ID EP347405
- DOI 10.17352/2455-3476.000020
- Views 82
- Downloads 0
New methods for bleeding monitoring
Bleeding is a potentially preventable reason of the death among patients during major surgery. Appropriate monitorization is necessary to perform optimum resuscitation. However, conventional coagulation tests have some l...
Combined Techniques in Difficult Airway Management
Difficult or failed tracheal intubation is an important cause of mortality and morbidity. Approximately 30% of anesthesia-related deaths are caused by the complications of difficult airway management. Also, 85% of respir...
Opioid Antagonists: Will they Solve all of the Problems Associated with Opioid Agonists?
Physicians employed in operating and emergency rooms have utilized opioid antagonist for almost half a century for the treatment of opioid overdose. The prototype antagonist remains naloxone hydrochloride, which actually...
Oxygen Aspects on Sensing and Utilization
Oxygen is known to be one of the strongest electron acceptors and has one of its main functions in the electron transport chain producing ATP and heat, so important for energy expenditure and thermoregulation. However, s...
Emergent Cervical Decompression in a Child with MURCS Association
This case report describes an unusual presentation and anesthesia management of a rare genetic association. The MURCS association, a variant of Mayer-Rokitansky-Küster-Hauser syndrome is a rare (1/4500-1/50,000) congenit...