Anästhesie und klinische Forschung
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Abstrakt

Paravertebral Block vs. Caudal Block Using Dexmedetomidine Plus Local Anesthetics for Inguinal Hernia Repair in Pediatrics: A Randomized Prospective Trial

Naglaa Khalil and Hesham M Marouf

Aim: We aimed to compare the effects of caudal block (CB) and paravertebral block (PVB) using dexmedetomidine plus local anesthetics on postoperative pain and analgesia requirements in pediatrics after inguinal hernia surgery.

Methods: This randomized prospective study was carried out on 80 pediatric patients underwent inguinal hernia repair. Two groups (each 40 patients) were included in the study: group CB and group PVB. After a standardized general anaesthesia, caudal or lumbar paravertebral block was performed using bupivacaine (0.25%) and dexemetomidine 1 μg/kg . We recorded FLACC score, number of patients needed rescue analgesia, the total number of doses of rescue analgesia, the duration of postoperative analgesia, parents satisfaction and adverse events.

Results: FLACC score was higher in group (CB) compared with group (PVB) at 12 h and 16 h postoperative. The total number of patients need postoperative analgesia and the total number of doses of postoperative analgesia were higher in group (CB) compared with group (PVB). The duration of postoperative analgesia was significantly longer in group (PVB) than group (CB) (16.25 ± 1.66 vs. 10.69 ± 1.34). Parent satisfaction was higher in group (PVB) than group (CB). No major complications were detected in both groups.

Conclusion: paravertebral block (using dexmedetomidine+local anaesthetics) was associated with better postoperative analgesia and higher parents satisfaction compared to caudal block (using dexmedetomidine+local anaesthetics) for inguinal hernia repair in children.