• Bjoern Grosse, Stefan Eberbach, Hans O Pinnschmidt, Deirdre Vincent, Martin Schmidt-Niemann, and Konrad Reinshagen.
• Department of Pediatric Anesthesiology, Altona Children's Hospital, Bleickenallee 38, 22763, Hamburg, Germany. Bjoern.Grosse@kinderkrankenhaus.net.
• BMC Anesthesiol. 2020 Oct 3; 20 (1): 256.

BackgroundIlioinguinal-iliohypogastric block (ILIHB) is a well-established procedure for postoperative analgesia after open inguinal surgery in children. This procedure is effective and safe, especially when ultrasound is used. Data availability for comparing ultrasound-guided blocks versus wound infiltration is still weak. The study was designed to determine the efficacy of ultrasound-guided ILIHB (US-ILIHB) on postoperative pain control in pediatric patients following a inguinal daycase surgery, compared with perifocal wound infiltration (PWI) by the surgeon.MethodsThis randomized, double-blinded trail was conducted in pediatric patients aged from 6 months to 4 years. The total number of children included in the study was 103. Patients were allocated at random in two groups by sealed envelopes. The ILIHB group recieved 0,2% ropivacain for US-ILIHB after anesthesia induction. The PWI group recieved 0,2% ropivacain for PWI performed by a surgeon before wound closure. Parameters recorded included the postoperative pain score, pain frequency, time to first analgesics and consumption of analgesics.ResultsUS-ILIHB significantly reduced the occurrence of pain within the first 24 h after surgery (7.7%, p = 0.01). Moreover, the pain-free interval until administration of the first dose of opioids was 21 min longer, on average (p = 0.003), following US-ILIHB compared to perifocal wound infiltration. 72% of children who received US-ILIHB did not require additional opioids, as compared to 56% of those who received PWI.ConclusionThus our study demonstrates that US-ILIHB ensures better postoperative analgesia in children and should be prioritized over postoperative PWI.Trail RegistrationUIHBOPWIIC, DRKS00020987 . Registered 20 March 2020 - Retrospectivley registered.

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