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This study compares the transversalis fascia plane block with the ilioinguinal/iliohypogastric nerve block in children undergoing hernia repair surgery.
Half of participants will receive the transversalis fascia plane block, while the other will receive the ilioinguinal/iliohypogastric nerve block.
The ilioinguinal/iliohypogastric nerve block (II/IH B)is a widely used regional anesthesia technique in inguinal hernia repair surgery. However, this block provides limited analgesia during and after surgery, and the patients feel pain when walking. The transversalis fascia plane block (TFPB) is a recently developed technique and several case reports presented its efficacy for inguinal repair surgery in adult patients. It may block not only ilioinguinal and iliohypogastric nerves but also splanchnic nerves, which is conveyed via the thoracolumbar fascia. Therefore, we compare the effect of the TFPB and II/IH B on postoperative pain and walking form.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Transversalis Fascia Plane Block | Experimental | receive transversalis fascia plane block with 0.4 ml/kg of 0.25% levobupivacaine after establishment of general anesthesia. |
|
| Ilioinguinal/iliohypogastric Nerve Block | Active Comparator | receive ilioinguinal/iliohypogastric nerve block with 0.1 ml/kg of 0.25% levobupivacaine after establishment of general anesthesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transversalis Fascia Plane Block | Drug | block will be performed under real-time ultrasound guidance |
|
| Measure | Description | Time Frame |
|---|---|---|
| walking appearance | scoring a way of walking; 0: brisk walk, big step, able to skip (= no pain) to 5: not able to stand up ( = worst pain) | 3 to 5 hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| FLACC (face, legs, activity, cry, consolability) score | behavioral pain scale in children. Each category has 0 to 2 score; Total 0 (no pain) to 10 (worst) | 3 to 5 hours after surgery |
| Faces Pain Scale revised |
| Measure | Description | Time Frame |
|---|---|---|
| intraoperative heart rate changes | heart rate during surgery | just before surgery start, one minute after incision, maximum value during surgery |
| intraoperative respiratory rate changes | respiratory rate during surgery |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kazuhiko Okuyama, MD | Ibaraki Children's Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ibaraki Children's Hospital | Mito | Ibaraki | 311-4145 | Japan |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| Ilioinguinal/iliohypogastric Nerve Block | Drug | block will be performed under real-time ultrasound guidance |
|
|
self-reported pain score. Children choose a face from six faces.
| 3 to 5 hours after surgery |
| additional pain curer usage | request or necessity of administration of acetaminophen or flurbiprofen | up to 5 hours after surgery |
| just before surgery start, one minute after incision, maximum value during surgery |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |