Comparison Between Caudal Epidural And Ultrasound Guided Ilioinguinal-Iliohypogastric nerve block (both are techniques to reduce pain after inguinal hernia surgery) with Dexmedetomidine For pain relief after the inguinal hernia surgery in children; A Prospective, Randomised, study

Completed

• Conditions: children between 1 to 10 years undergoing unilateral inguinal hernial repair

• Registration Number: CTRI/2018/01/011327
• Lead Sponsor: Dr Varsha R

Brief Summary

**Backgroundand Objectives:**Caudal Epidural and Ilioinguinal, Iliohypogastric nerve (IL/IH) Blocks arecommonly used regional anaesthesia techniques to provide post-operative analgesiain paediatric inguinal surgeries. Dexmedetomidine as an adjuvant has proven toprolong the duration of regional anaesthesia. There are no studies comparingthe analgesia provided by local anaesthetic with dexmedetomidine for caudal andultrasound guided IL/IH block for paediatric inguinal surgeries.

**Materialsand Methods:**  Forty six patients undergoing inguinal herniarepair were selected for this randomised double blind study. After generalanaesthesia, children received either 0.75 ml.kg-1 of 0.25%bupivacaine with 1 mcg.kg-1 of dexmedetomidine in caudal epiduralgroup or 0.25 ml.kg-1 of 0.25% bupivacaine with 1 mcg.kg-1of dexmedetomidine in ultrasound guided IL/IH block group. Postoperative painwas assessed 24-hours postoperatively using FLACC score. For FLACC > 4,rescue analgesia was provided using intravenous Fentanyl, within first 2-hoursand with oral Ibuprofen between 2-24 postoperative hours. The time for firstrescue analgesic was taken as the duration of analgesia.

**Results:** The duration ofanalgesia of caudal and ultrasound guided IL/IH (USG-IL/IH) blocks were 730±430minutes and 808±453 minutes respectively, which was statistically notsignificant. Average time to perform caudal block was significantly highercompared to IL/IH (547±93 vs. 317±179 seconds).There were no significantcomplications in either group.

**Conclusion:**Bothcaudal epidural and USG-IL/IH block with dexmedetomidine are equally efficaciousin prolonging the analgesic duration with no significant side-effects. We foundthat USG-IL/IH block was much faster and easier to perform as compared tocaudal epidural.

Detailed Description

Not available

Study Timeline

• Study Start: 2015-04-11
• Study Completion: 2017-11-15
• Last Update Posted: 2018-12-01

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 46

Inclusion Criteria

• ASA class I and II, 2.
• Age between age of 1 to 10 years, 3.
• Scheduled to undergo unilateral hernia and hydrocele repair.

Exclusion Criteria

• Children with active upper or lower respiratory tract infection 2.
• Bleeding disorders 3.
• Neuromuscular abnormalities 4.
• Deformities of the caudal space 5.
• Those allergic to NSAID’s or any of the other drugs used in the study.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
paediatric pain score- FLACC	postoperative period up to 24 hours

Secondary Outcome Measures

Name	Time	Method
Total analgesic consumption	up 24 hours Postoperatively
Time for performance of Block	Intraoperatively
Parents Satisfaction	24 hours Postoperatively

Trial Locations

Locations (1)

SDM College of Medical Sciences and Hospital; 🇮🇳 Dharwad, KARNATAKA, India

SDM College of Medical Sciences and Hospital

🇮🇳Dharwad, KARNATAKA, India

Dr Varsha R

Principal investigator

9481820424

rudrahitluvarshask@gmail.com