To evaluate the efficacy of ilioinguinal or iliohypogastric nerve block in pediatric ambulatory surgery.

From November 2011 To April 2012, a total of 60 pediatric patients, who were scheduled for elective inguinal hernia or hydrocele, were enrolled into the study. According to the methods of anesthesia, they were randomly allocated using a computer-generated sequence of numbers to one of the three groups: Group Le (group levobupivacaine, n=20), group Li (group lidocaine, n=20), control group(n=20). In all three groups, penehyclidine hydrochloride(0.01 mg/kg), ketamine(2 mg/kg) and propofol(2 mg/kg) were given to perform basis anesthesia. Children in groups Le and Li received an ilioinguinal or iliohypogastric block under ultrasonic diagnosis with 0.25% levobupivacaine and 2% lidocaine at 0.5 mL/kg, respectively. Children in control group just received ketamine(1 mg/kg) and propofol (2 mg/kg) anesthesia during surgical sterilization. During surgery, dosages and times of additional ketamine and postoperative recovery time were recorded. The vital signs of heart rate(HR), respiratory rate(RR), pulse oxygen saturation (SpO₂), mean arterial pressure(MAP) were recorded in five time points during surgery: the basal(T0), anesthesia induction(T1), the skin incision(T2), pulling hernial sac(T3), seaming the skin(T4). And intra-or postoperation adverse events of urine retention, pruritus, postoperative nausea and vomiting(PONV) were also recorded. Face legs activity cry consolability(FLACC) score was used to assess the pain score postoperatively at 2 h, 4 h, 6 h postoperation respectively.(This clinical trial was reviewed and approved by the Ethiscs Committee of the hospital. For each pediatric patient , written informed consent was obtained from his or her parents of legal guardians).

① The demographic data of age, weight, gender, the kinds of surgery, and surgery time were no significantly difference(P>0.05). ②MAP, HR, and RR at T2 and T3 in group Li and Le were significantly higher than those in control group(P<0.05). MAP, HR, and RR at T2 and T3 were significantly difference than those at T0 in control group(P<0.05). ③The dosages and times of additional ketamine in control group were significantly more than those in group Li and Le(P<0.05), and the dosages and times of additional ketamine in group Li were significantly more than those in group Le(P<0.05). The recovery time in control group were significantly longer than those in group Li and Le(P<0.05). ④The FLACC pain scores at 2 h, 4 h, 6 h postoperation in control group were significantly higher than those in group Li and Le(P<0.05), the FLACC pain scores at 6 h postoperation in group Li was significantly than those in group Le(P<0.05). The incidences of PONV in groups Le and Li were significantly lower than those in control group(P<0.05), and there was no significantly differences in incidences of urine retention and pruritus among the three groups(P>0.05).

With good anesthesia/postoperative analgesia and less complications, ilioinguinal or iliohypogastric nerve block in pediatric ambulatory surgery is both feasible and effective.