ABSTRACT
Ilioinguinal and iliohypogastric nerve blocks has been widely used in children undergoing inguinal herniorraphy. This technique may provide insufficient intraoperative analgesia as the inguinal region may receive innervation from genitofemoral nerve. We proposed that the addition of genitofemoral nerve block might improve the quality of analgesia. The objective was to find the efficacy of genitofemoral nerve block in addition to ilioinguinal and iliohypogastric nerve block for better intraoperative pain management in children under going inguinal hernia repair under general anaesthesia. After informed consent, 100 children of 1-10 yrs of age and ASA I or II status undergoing inguinal hernia repair were selected and divided in group I and II of 50 patients each. After induction of general anaesthesia, Group I patients received ilioinguinal and iliohypogastric block using bupivacaine 0.375% at a dose of 0.75 mg/kg, where as patients in group II were given genitofemoral in addition to ilioinguinal and iliohypogastric nerve blocks using bupivacaine 0.375% at a dose of 0.375 mg/kg at each site. Changes in heart rate, systolic, diastolic and mean arterial pressures were recorded before the start of surgery, at skin incision, at sac traction and at the end of surgery as a measure of efficacy of the block. Haemodynamic data was analysed using repeated measures ANOVA. The two groups showed increase in [Heart Rate] but the increase was lesser in group II at sac traction [p<0.05]. In group I all patients had an increase in systolic, diastolic and mean arterial pressure at sac traction while the patients in group II showed no change during the study period [p<0.05]. We conclude that the addition of a genitofemoral nerve block to ilioinguinal and iliohypogastric nerve blocks may contribute to haemodynamic stability during sac traction indicating better pain relief