ABSTRACT
Background and Objective: Infants and children undergo a variety of groin procedures that can cause a significant degree ofdiscomfort postoperatively. We aim to compare the caudal block and ilioinguinal/iliohypogastric block using the combination ofropivacaine and dexmedetomidine with regard to efficacy, quality, and duration of post-operative analgesia.Methods: This study included two groups and 60 patients of the age group of 3–12 years. After induction of anesthesia, GroupAreceived caudal block using 1 ml/kg 0.2% ropivacaine + dexmedetomidine 0.3 μg/kg up to maximum of 20 ml. Group B receivednerve locator guided ilioinguinal/iliohypogastric block using 0.75 ml/kg 0.2% ropivacaine + dexmedetomidine 0.3 μg/kg up tomaximum of 20 ml. Postoperatively, patients were monitored for up to 24 h for primary objective of measurement of pain score,duration of analgesia, and number of rescue analgesia required. Statistical analysis performed using independent t-test andChi-square test. P < 0.05 was considered statistically significant.Results: The highest pain score in Group A was 5.93 ± 1.53 and in Group B was 4.93 ± 1.64 (P < 0.05). The average durationof analgesia in Group A and Group B was 372 min and 680 min, respectively (P < 0.05). The mean number of rescue analgesiagiven in Group A was 1.47 and in Group B was 0.96 (P < 0.05).Conclusion: Both caudal block and ilioinguinal block are effective measure of post-operative pain relief in pediatric inguinalsurgeries, but ilioinguinal block is better in terms of efficacy, duration of analgesia, lesser dose of local anesthetic required, andlesser need of rescue analgesia required.
ABSTRACT
Background: Adequate post-operative analgesia is the prime duty of anesthesiologist and several adjuvants have been usedalong with local anesthetics to prolong the duration of brachial plexus block. The present study aimed to compare the effect ofnalbuphine and magnesium sulfate as an adjuvant to ropivacaine and ropivacaine alone in nerve stimulator guided supraclavicularbrachial plexus block in patients scheduled for orthopedic upper limb surgeries.Materials and Methods: A total of 90 patients of in the age group of 20–65 years of either sex of the American Society ofAnesthesiologists Grade I and II were divided into three groups of 30 each. Group R received 30 ml of 0.75% ropivacaine alone,Group RM received 30 ml of 0.75% ropivacaine plus 150 mg of magnesium sulfate, and Group RN received 30 ml of 0.75%ropivacaine plus 20 mg of nalbuphine. All the groups were compared with respect to onset and duration of sensory and motorblockade, post-operative analgesia, need for rescue analgesia, hemodynamics, and side effects.Results: Onset of sensory and motor block was earliest in Group RN and was highly significant (P < 0.001) when compared toGroup R and Group RM. Mean duration of post-operative analgesia was 8.70 ± 1.18 h in Group R, 11.73 ± 1.23 h in Group RM,and 14.40 ± 1.25 in Group RN. Duration of sensory and motor block and post-operative analgesia were significantly prolonged(P < 0.001) both in Group RM and Group RN when compared to Group R.Conclusion: Both nalbuphine and magnesium sulfate are effective adjuvant as compared to ropivacaine alone as they prolong theduration of block as well as post-operative analgesia when used for supraclavicular brachial plexus block. However, nalbuphinehas proven to be a better adjuvant as compared to magnesium sulfate as it also results in earlier onset of sensory and motorblock and better patient and surgeon satisfaction scores.