Ultrasound-guided Ilioinguinal/Iliohypogastric Nerve Block Compared to the Combined Therapy With Spermatic Cord Block
Condition: Hernia, Inguinal
MeSH terms: Hernia, Inguinal
Study type: Interventional
Phase: Phase 1

Summary: 
      This is a single center randomized, controlled, double-blinded, noninferiority study. Male
      pediatric patients who underwent inguinal herniotomy will be screened for eligibility.
      Patients will be randomly allocated to IINB and IINB/SCB groups with allocation ratio 1:1.
      The primary outcome measure will be the proportion of patients who needed rescue analgesia
      during the first postoperative 6 h. The secondary outcome measures will be intraoperative
      heart rate and mean arterial blood pressure (MAP), the postoperative pain FLACC pain scale,
      and intravenous paracetamol consumption, the incidence of adverse effects including hematoma,
      postoperative vomiting and fever.
    

Detailed description: 
      Inguinal herniotomy in children is a frequent surgical procedure that require good
      postoperative analgesia. Ultrasound-guided ilioinguinal/iliohypogastric nerve block is a
      widely validated anesthetic technique for this procedureز

      Currently, central neuraxial analgesic techniques have been replaced by ultrasoundguided
      interfascial plane blocks that have gained more popularity among anesthetists because they
      are safer, easily performed, associated with minor hemodynamic changes and can be done in the
      presence of contraindications of the neuraxial block .

      Ultrasound-guided ilioinguinal/iliohypogastric nerve block (IINB) is commonly done in
      pediatric patients to control pain after lower abdominal surgeries and has been shown to be
      effective in controlling pain after inguinal hernia repair .

      However IINB don't affect the genitofemoral neve that contributes the sensory innervation of
      the inguinal region. The spermatic cord (SC) is a unique male structure that contains the vas
      deferens, testicular arteries, the pampiniform plexus of veins, and the ilioinguinal nerve
      and genital branch of the genitofemoral nerve (GFN). To provide complete analgesia for
      inguinal hernia surgery, GFN should be blocked in addition to IINB .
    

Intervention name(s): Levobupivacaine; Ilioinguinal/iliohypogastric nerve block (IINB); IINB+ Spermatic cord block
Intervention type(s): Drug; Procedure; Procedure
Intervention description(s): Evaluation the postoperative analgesic effects by using ultrasound-guided spermatic cord block (SCB) and IINB in children scheduled for elective open inguinal herniotomy. The study hypothesized that, the combined block with SCB and IINB would result in more effective postoperative analgesia than the use of IINB alone.; Ilioinguinal/iliohypogastric nerve block (IINB); IINB+ Spermatic cord block
Intervention MeSH terms: Levobupivacaine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: inguinal herniotomy; ilioinguinal nerve block; iliohypogastric nerve block; spermatic cord block