Analgesic Effect of Ilioinguinal Nerve Block and Wound Irrigation Using Bupivacaine after Ambulatory Inguinoscrotal Surgery in Children

Choe, Jin Ho; Park, Kwan Hyun

Abstract

PURPOSE: A simple and safe method for postoperative analgesia is required for children, especially with ambulatory surgical procedures. This study aimed to investigate the analgesic effects of ilioinguinal nerve block, and wound irrigation using bupivacaine, compared with those in control after inguinoscrotal operation.
MATERIALS AND METHODS
Of 57 patients who underwent unilateral hydrocelectomy or orchiopexy, at our ambulatory surgery center, patients were randomly selected for ilioinguinal nerve block (group 1, n=19) or wound irrigation (Group 2, n=19) using bupivacaine. Normal saline was injected, or irrigated, into the control group (n=19). The analgesic effects were evaluated using the Oucher scale, every 30 min for 3h, and then at 6, 12 and 24h postoperatively, and the number of additional oral analgesic intakes recorded during the period.
RESULTS
All three groups were similar in age, type of procedures and duration of the operation or anesthesia. The pain scores were significantly lower in groups 1 and 2 compared to the control, and the pain score, 30 min after the operation, was significantly lower in group 2 than in group 1 (p=0.025, p=0.001 and p=0.045, respectively). Although the pain scores between the 3 groups showed no significantly difference following the procedure, a relatively higher pain score was noted in the control group after 150 min. In groups 1 and 2, there was a lesser number of analgesic intakes than required by the control, although this was not significantly different.
CONCLUSIONS
In ambulatory inguinoscrotal surgery, ilioinguinal nerve block, or wound irrigation, using bupivacaine, demonstrated similar analgesic effects in children. Wound irrigation was more effective than nerve block at 30 min postoperatively. Based on these data, wound irrigation or nerve block, using bupivacaine, with the addition of oral analgesics, will minimize the postoperative pain of ambulatory inguinoscrotal surgery in children.