Pan Li,1,2 Wen Tang1 

1Department of Anesthesiology, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, People’s Republic of China; 2Department of Anesthesiology, Jiangxi Children’s Medical Center/Jiangxi Hospital Affiliated with Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China

Correspondence: Wen Tang, Email tangwen102083@163.com

Objective: To investigate the efficacy of ultrasound-guided iliohypogastric and ilioinguinal nerve block for anesthesia in pediatric inguinal surgery.
Methods: A retrospective analysis was conducted on a cohort of 100 pediatric patients undergoing unilateral inguinal region surgeries at Chongqing Medical University Children’s Hospital from July to December 2019. The participants were stratified into two groups: Groin group and Navel-iliac group, each consisting of 50 patients. Key parameters including hemodynamics, respiratory dynamics, blood oxygen saturation, surgical and anesthesia-specific metrics, intraoperative and postoperative complications, postoperative pain management, and parental satisfaction were subjected to meticulous statistical scrutiny.
Results: Significantly divergent outcomes were observed between the Groin and Navel-iliac groups at T2 and T3. The Groin cohort displayed markedly lower heart rates, respiratory rates, mean arterial pressures, blood pressures, and blood oxygen saturation levels in comparison to the Navel-iliac group (P< 0.05). Furthermore, the Groin group exhibited shorter awakening times and reduced post-anesthesia care unit stays (P< 0.05), along with decreased usage of sufentanil and propofol (P< 0.05). Noteworthy reductions in the occurrences of intraoperative movement, postoperative nausea and vomiting, and postoperative agitation were noted in the Groin group (P< 0.05). The FLACC pain scores upon awakening and at the 2-hour postoperative mark were also notably lower in the Groin group (P< 0.05). Parental satisfaction within the Groin group was notably higher at 98.00% (49/50) compared to the Navel-iliac group’s 80.00% (40/50) (χ 2=8.274, P< 0.05). All children involved in the study and their legal guardians signed written informed consent after fully understanding the study.
Conclusion: The modified ultrasound-guided iliohypogastric and ilioinguinal nerve block is more effective than the traditional ultrasound-guided method for anesthesia in pediatric inguinal surgery. The Groin group method provides a safe and effective anesthesia, particularly for children with a low body mass index (BMI< 13.9).

Keywords: pediatric inguinal surgery, ultrasound-guided, iliohypogastric and ilioinguinal nerve block, analgesic efficacy, hemodynamics, complications