Burad Jyoti, Sen Amitabh, Narayanan Bhadrinath, Al Shuhoumi Fatma, Al Hashimi Safiya Hashim, Al Balushi AbdulMajeed, Al Yaqoubi Khadija, Jose Sachin, Al Balushi Zainab
Anesthesia and Intensive Care, Sultan Qaboos University Hospital, Muscat, OMN.
Biostatistics, Research Department, Oman Medical Specialty Board, Muscat, OMN.
Cureus. 2025 Jun 10;17(6):e85677. doi: 10.7759/cureus.85677. eCollection 2025 Jun.
Caudal nerve blocks are commonly used for inguinal surgeries in children but can lead to complications, such as prolonged weakness. The ilioinguinal/iliohypogastric (ILIH) nerve block is an alternative that is used less frequently. This study aimed to compare the effectiveness of these techniques in pediatric patients (ages six months to 12 years) undergoing inguinal surgery.
A double-blinded, randomized controlled trial was conducted with 20 pediatric patients undergoing inguinal surgery under general anesthesia. Group 1 (n = 8) received a caudal block, while Group 2 (n = 12) received an ILIH block. Pain was assessed using the Face, Legs, Activity, Cry and Consolability (FLACC) and Numeric Rating score (NRS). The primary outcomes included pain reduction and the use of rescue analgesia.
The mean age of Group 1 was 2.13 years (SD=1.356), while that of Group 2 was 3.67 years (SD=1.303). The pain scores were 1.75 (SD=2.235) and 1.25 (SD=1.658) (p=0.792) at 30 minutes post-surgery in the Post Anesthesia Care Unit (PACU), 0.50 (SD=0.756) versus 0.08 (SD=0.289) (p=0.792) at PACU discharge, a score of zero versus 0.58 (SD=0.900) (p=0.792) at two hours post-operation for Group 1 and Group 2 respectively. Pain scores were similar at three hours, six hours, and at ward discharge. On day two at home, Group 1 reported a score of 0.25 (SD=0.707) compared to 0.33 (SD=0.778) in Group 2 (p=0.792). The use of rescue analgesia was higher in the caudal group, but the difference was statistically insignificant (p=0.7055). The block to ward discharge time was similar: 283 (SD=102.182) minutes versus 309.83 (SD=79.409) minutes for Group 1 and Group 2, respectively (p=0.746).
Both caudal and ILIH blocks provided similar analgesic effects for pediatric inguinal surgery. More extensive studies are needed to confirm this conclusion.
骶管神经阻滞常用于儿童腹股沟手术，但可能导致诸如肌无力持续时间延长等并发症。髂腹股沟/髂腹下神经阻滞是一种较少使用的替代方法。本研究旨在比较这些技术在接受腹股沟手术的儿科患者（6个月至12岁）中的有效性。
对20例在全身麻醉下接受腹股沟手术的儿科患者进行了一项双盲随机对照试验。第1组（n = 8）接受骶管阻滞，而第2组（n = 12）接受髂腹股沟/髂腹下神经阻滞。使用面部、腿部、活动、哭闹和安慰度（FLACC）及数字评分量表（NRS）评估疼痛。主要结局包括疼痛减轻情况及补救性镇痛药物的使用。
第1组的平均年龄为2.13岁（标准差=1.356），而第2组为3.67岁（标准差=1.303）。在麻醉后护理单元（PACU）术后30分钟时，疼痛评分分别为1.75（标准差=2.235）和1.25（标准差=1.658）（p = 0.792）；在PACU出院时，分别为0.50（标准差=0.756）和0.08（标准差=0.289）（p = 0.792）；第1组和第2组在术后2小时的评分分别为0分和0.58（标准差=0.900）（p = 0.792）。在术后3小时、6小时及病房出院时，疼痛评分相似。在术后第二天在家中时，第1组报告的评分为0.25（标准差=0.707），而第2组为0.33（标准差=0.778）（p = 0.792）。骶管阻滞组补救性镇痛药物的使用更高，但差异无统计学意义（p = 0.7055）。至病房出院的阻滞时间相似：第1组为283（标准差=102.182）分钟，第2组为309.83（标准差=79.409）分钟（p = 0.746）。
骶管阻滞和髂腹股沟/髂腹下神经阻滞在儿科腹股沟手术中提供了相似的镇痛效果。需要更广泛的研究来证实这一结论。
