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Çocuk Hastalarda İlioinguinalL/İliohipogastrik Sinir Bloğunda Bupivakain ve Levobupivakainin Postoperatif Ağrıya Etkilerinin Karşılaştırılması: Retrospektif Çalışma

Year 2017, Volume: 7 Issue: 3, 120 - 124, 30.09.2017
https://doi.org/10.31832/smj.318124

Abstract

Amaç: Genel anesteziye eklenen ilioinguinal/iliohipogastrik
(İİ/İH) sinir bloğu pediyatrik hastalarda postoperatif analjezi için sıklıkla
kullanılmaktadır. Daha önce araştırılmadığından dolayı, pediyatrik hastalarda
inguinal herni onarımı için İİ/İH sinir bloğunda uygulanan bupivakain ve
levobupivakainin postoperatif analjezik etkilerini karşılaştırmayı amaçladık.

Gereç ve Yöntem: Bu 2 yıllık retrospektif çalışmada, veriler tek
taraflı kasık fıtığı ameliyatı yapılan hastaların tıbbi kayıtlarından elde
edildi. 0.2 mL/kg %0.5 bupivakain (Grup B) veya levobupivakain (Grup L) ile İİ/İH
sinir bloğu uygulanan hastalar alındı. Elektif olmayanlar, 2 yaş altı hastalar ve
birden fazla cerrahi prosedür içerenler çalışma dışı bırakıldı. Hastaların
demografik özellikleri (yaş, kilo ve cinsiyet), cerrahi süre ve taraf, ağrı
skorları, ek analjezik gereksinimi ve komplikasyonlar kayıt altına alındı.
İstatistiksel analiz için Ki-kare testi ve Mann-Whitney U testi kullanıldı. 

Bulgular: Her iki gruptaki ağrı skorları post-anestezi bakım
ünitesinde, 1, 2, 6 ve 24. saatlerde farklı değildi. Bununla birlikte, 4.
saatteki ağrı skorları Grup L'de anlamlı derecede düşüktü.







Sonuçlar: Genel anesteziye eklenen İİ/İH sinir bloğu,
postoperatif ağrı kontrolünde pediyatrik hastaların inguinal bölge cerrahisinde
etkilidir ve %0.5 levobupivakain ve bupivakainin benzer analjezik etkisi
vardır.

References

  • Markakis DA. Regional anesthesia in pediatrics. Anesthesiol Clin North America 2000; 18: 355-381.
  • Disma N, Tuo P, Pellegrino S, Astuto M. Three concentrations of levobupivacaine for ilioinguinal/iliohypogastric nerve block in ambulatory pediatric surgery. J Clin Anesth 2009; 21:389-393.
  • Kundra P, Sivashanmugam T, Ravishankar M. Effect of needle insertion site on ilioinguinal-iliohypogastric nerve block in children. Acta Anaesthesiol Scand 2006; 50:622-626.
  • Ala-Kokko TI, Karinen J, Raiha E, Kiviluoma K, Alahuhta S. Pharmacokinetics of 0.75% ropivacaine and 0.5% bupivacaine after ilioinguinal-iliohypogastric nerve block in children. Br J Anaesth 2002; 89:438-441.
  • Ivani G, Borghi B, van Oven H. Levobupivacaine. Minerva Anestesiol 2001; 67:20-23.
  • Gunter JB, Gregg T, Varughese AM, et al. Levobupivacaine for ilioinguinal/iliohypogastric nerve block in children. Anesth Analg 1999; 89:647-649.
  • Kokki H, Ylonen P, Heikkinen M, Reinikainen M. Levobupivacaine for pediatric spinal anesthesia. Anesth Analg 2004; 98:64-67.
  • Beyaz SG. Comparison of postoperative analgesic efficacy of caudal block versus dorsal penile nerve block with levobupivacaine for circumcision in children. Korean J Pain 2011; 24:31-35.
  • Willschke H, Marhofer P, Bösenberg A, et al. Ultrasonography for ilioinguinal/iliohypogastric nerve blocks in children. Br J Anaesth 2005; 95:226-230.
  • Foster RH, Markham A. Levobupivacaine: a review of its pharmacology and use as a local anaesthetic. Drugs 2000; 59:551-559.
  • Mazoit J-X, Dalens BJ. Pharmacokinetics of local anaesthetics in infants and children. Clin Pharmacokinet 2004; 43:17-32.
  • Ingelmo PM, Locatelli BG, Sonzogni V, et al. Caudal 0.2% ropivacaine is less effective during surgery than 0.2% levobupivacaine and 0.2% bupivacaine: a double-blind, randomized, controlled trial. Paediatr Anaesth 2006; 16:955-961.
  • Weintraud M, Marhofer P, Bösenberg A, et al. Ilioinguinal/iliohypogastric blocks in children: where do we administer the local anesthetic without direct visualization? Anesth Analg 2008; 106:89-93.
  • Abdellatif AA. Ultrasound-guided ilioinguinal/iliohypogastric nerve blocks versus caudal block for postoperative analgesia in children undergoing unilateral groin surgery. Saudi J Anaesth 2012; 6:367-372.
  • Seyedhejazi M, Daemi OR, Taheri R, Ghojazadeh M. Success rate of two different methods of ilioinguinal-iliohypogastric nerve block in children inguinal surgery. Afr J Paediatr Surg 2013; 10:255-258.
  • Sasaoka N, Kawaguchi M, Yoshitani K, Kato H, Suzuki A, Furuya H. Evaluation of genitofemoral nerve block, in addition to ilioinguinal and iliohypogastric nerve block, during inguinal hernia repair in children. Br J Anaesth 2005; 94:243-246.
  • Ala-Kokko TI, Raiha E, Karinen J, Kiviluoma K, Alahuhta S. Pharmacokinetics of 0.5% levobupivacaine following ilioinguinal-iliohypogastric nerve blockade in children. Acta Anaesthesiol Scand 2005; 49:397-400.
  • Willschke H, Bösenberg A, Marhofer P, et al. Ultrasonographic-guided ilioinguinal/iliohypogastric nerve block in pediatric anesthesia: what is the optimal volume? Anesth Analg 2006; 102:1680-1684.

COMPARISON OF BUPIVACAINE AND LEVOBUPIVACAINE ON POSTOPERATIVE PAIN AFTER ILIOINGUINAL/ILIOHYPOGASTRIC NERVE BLOCK IN PEDIATRIC PATIENTS: A RETROSPECTIVE STUDY

Year 2017, Volume: 7 Issue: 3, 120 - 124, 30.09.2017
https://doi.org/10.31832/smj.318124

Abstract

Objective: Ilioinguinal/iliohypogastric
(II/IH) nerve block added to general anesthesia is frequently used for
postoperative analgesia in pediatric patients. We aimed to compare the
postoperative analgesic effects of bupivacaine and levobupivacaine for II/IH
nerve block for inguinal hernia repair in pediatric patients, which is not investigated
previously.

Materials and Methods: In this 2-year retrospective study, data were collected from the medical
charts of patients that underwent unilateral inguinal hernia repair. Patients
were included who received an II/IH nerve block with 0.2 mL/kg 0.5% of either
bupivacaine (Group B) or levobupivacaine (Group L). Non-elective cases, age
under 2 years and patients with multiple procedures were excluded. Demographic
properties of the patients (age, weight, and sex), duration and side of
surgery, pain scores, additional analgesic requirement and complications were
documented. The chi-square test and the Mann-Whitney U test were used for
statistical analysis.

Results: In both groups, the
pain scores were not significantly different at post anesthesia care unit, 1,
2, 6 and 24th hours; nevertheless, the pain scores at 4th hour were
significantly lower in Group L.







Conclusion: II/IH
nerve block added to general anesthesia is effective in inguinal region surgery
of pediatric patients in postoperative pain control, and 0.5% levobupivacaine
and bupivacaine had similar analgesic effect.

References

  • Markakis DA. Regional anesthesia in pediatrics. Anesthesiol Clin North America 2000; 18: 355-381.
  • Disma N, Tuo P, Pellegrino S, Astuto M. Three concentrations of levobupivacaine for ilioinguinal/iliohypogastric nerve block in ambulatory pediatric surgery. J Clin Anesth 2009; 21:389-393.
  • Kundra P, Sivashanmugam T, Ravishankar M. Effect of needle insertion site on ilioinguinal-iliohypogastric nerve block in children. Acta Anaesthesiol Scand 2006; 50:622-626.
  • Ala-Kokko TI, Karinen J, Raiha E, Kiviluoma K, Alahuhta S. Pharmacokinetics of 0.75% ropivacaine and 0.5% bupivacaine after ilioinguinal-iliohypogastric nerve block in children. Br J Anaesth 2002; 89:438-441.
  • Ivani G, Borghi B, van Oven H. Levobupivacaine. Minerva Anestesiol 2001; 67:20-23.
  • Gunter JB, Gregg T, Varughese AM, et al. Levobupivacaine for ilioinguinal/iliohypogastric nerve block in children. Anesth Analg 1999; 89:647-649.
  • Kokki H, Ylonen P, Heikkinen M, Reinikainen M. Levobupivacaine for pediatric spinal anesthesia. Anesth Analg 2004; 98:64-67.
  • Beyaz SG. Comparison of postoperative analgesic efficacy of caudal block versus dorsal penile nerve block with levobupivacaine for circumcision in children. Korean J Pain 2011; 24:31-35.
  • Willschke H, Marhofer P, Bösenberg A, et al. Ultrasonography for ilioinguinal/iliohypogastric nerve blocks in children. Br J Anaesth 2005; 95:226-230.
  • Foster RH, Markham A. Levobupivacaine: a review of its pharmacology and use as a local anaesthetic. Drugs 2000; 59:551-559.
  • Mazoit J-X, Dalens BJ. Pharmacokinetics of local anaesthetics in infants and children. Clin Pharmacokinet 2004; 43:17-32.
  • Ingelmo PM, Locatelli BG, Sonzogni V, et al. Caudal 0.2% ropivacaine is less effective during surgery than 0.2% levobupivacaine and 0.2% bupivacaine: a double-blind, randomized, controlled trial. Paediatr Anaesth 2006; 16:955-961.
  • Weintraud M, Marhofer P, Bösenberg A, et al. Ilioinguinal/iliohypogastric blocks in children: where do we administer the local anesthetic without direct visualization? Anesth Analg 2008; 106:89-93.
  • Abdellatif AA. Ultrasound-guided ilioinguinal/iliohypogastric nerve blocks versus caudal block for postoperative analgesia in children undergoing unilateral groin surgery. Saudi J Anaesth 2012; 6:367-372.
  • Seyedhejazi M, Daemi OR, Taheri R, Ghojazadeh M. Success rate of two different methods of ilioinguinal-iliohypogastric nerve block in children inguinal surgery. Afr J Paediatr Surg 2013; 10:255-258.
  • Sasaoka N, Kawaguchi M, Yoshitani K, Kato H, Suzuki A, Furuya H. Evaluation of genitofemoral nerve block, in addition to ilioinguinal and iliohypogastric nerve block, during inguinal hernia repair in children. Br J Anaesth 2005; 94:243-246.
  • Ala-Kokko TI, Raiha E, Karinen J, Kiviluoma K, Alahuhta S. Pharmacokinetics of 0.5% levobupivacaine following ilioinguinal-iliohypogastric nerve blockade in children. Acta Anaesthesiol Scand 2005; 49:397-400.
  • Willschke H, Bösenberg A, Marhofer P, et al. Ultrasonographic-guided ilioinguinal/iliohypogastric nerve block in pediatric anesthesia: what is the optimal volume? Anesth Analg 2006; 102:1680-1684.
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Sevtap Darcin This is me

Ayca Tas Tuna This is me

İbrahim Akkoyun

Melahat Kececioglu This is me

Onur Palabiyik 0000-0003-3876-4279

Publication Date September 30, 2017
Submission Date July 4, 2017
Published in Issue Year 2017 Volume: 7 Issue: 3

Cite

AMA Darcin S, Tas Tuna A, Akkoyun İ, Kececioglu M, Palabiyik O. COMPARISON OF BUPIVACAINE AND LEVOBUPIVACAINE ON POSTOPERATIVE PAIN AFTER ILIOINGUINAL/ILIOHYPOGASTRIC NERVE BLOCK IN PEDIATRIC PATIENTS: A RETROSPECTIVE STUDY. Sakarya Tıp Dergisi. September 2017;7(3):120-124. doi:10.31832/smj.318124

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