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Background: Although Inguinal herniotomy in children is taken as a day care procedure, post-operative pain management still remain controversial in these cases and superiority of wound infiltration, caudal block or regional block over each isn't known.
Objective: The objective of the study was compare regional block, caudal block and wound infiltration for post-operative pain management in children undergoing inguinal herniotomy
Three hundred patients rom the department of pediatric surgery, KEMU/Mayo Hospital, were randomized in three study groups by a computer generated table. Regional block group (Group A), wound infiltration group (Group B), caudal block group (Group C). . Patients were assessed for postoperative pain intensity using FLACC pain scale at 0, 1, 2, 4, 8, 24 hours after surgery in children less than 8 years of age. Wong-Baker Faces pain Scale at 0, 1, 2, 4, 8, 24 hours after surgery in children more than 8 years of age. Patients were discharged after 24 hours. If pain score ≥ 4 was given intravenously, Ketoralac. Urinary retention was observed after 24 hours, wound infection was observed after 7 days.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A | Active Comparator | In group A, iliohypogastric and ilioinguinal nerves were blocked by using 0.25% bupivacaine 2ml/kg of combined with skin infiltration of adrenaline 1:200 000. |
|
| Group B | Active Comparator | In group B 0.25% bupivacaine 0.5ml/Kg was infiltrated at the surgical site. |
|
| Group C | Experimental | In group C 0.25% Bupivacaine 1ml /kg was given into epidural space at L4-L5 or L5-S1. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| regional block | Procedure | In group A, iliohypogastric and ilioinguinal nerves were blocked by using 0.25% bupivacaine 2ml/kg of combined with skin infiltration of adrenaline 1:200 000. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain intensity | Patients were assessed for postoperative pain intensity using FLACC pain scale at 0, 1, 2, 4, 8, 24 hours after surgery in children less than 8 years of age. Wong-Baker Faces pain Scale at 0, 1, 2, 4, 8, 24 hours after surgery in children more than 8 years of age. | 24 hours |
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| Measure | Description | Time Frame |
|---|---|---|
| postoperative pain intesity | Wong-Baker Faces pain Scale at 0, 1, 2, 4, 8, 24 hours after surgery in children more than 8 years of age. | 24 hours |
Inclusion Criteria:
.Irreducible, obstructed or strangulated hernia, documented on clinical examination.
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| Name | Affiliation | Role |
|---|---|---|
| Muhammad Sharif, FCPS | King edward Medical University/Mayo Hospital Lahore | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Muhammad Sharif | Lahore | Punjab Province | 53711 | Pakistan |
will be shared on request
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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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| ID | Term |
|---|---|
| D002045 | Bupivacaine |
| D007268 | Injections, Epidural |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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Regional block group (Group A), wound infiltration group (Group B), caudal block group (Group C)
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|
| Caudal block | Procedure | In group B 0.25% bupivacaine 0.5ml/Kg was infiltrated at the surgical site. |
|
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| Epidural | Procedure | In group C 0.25% Bupivacaine 1ml /kg was given into epidural space at L4-L5 or L5-S1. |
|
|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D000588 |
| Amines |
| D007278 | Injections, Spinal |
| D007267 | Injections |
| D004333 | Drug Administration Routes |
| D004358 | Drug Therapy |
| D013812 | Therapeutics |