Abstract:
Objective: This prospective study aimed to compare the efficacy of caudal block (CB) and ilioinguinal/iliohypogastric nerve block (IINB) for providing additional analgesia during unilateral orchidopexy. Methods: Seventy-one boys aged <48 months, classified as ASA I/II, were assigned into CB (n = 37) and IINB (n = 34) groups. Outcome measures included intra- and postoperative analgesic requirements, pain scores, and administration duration. Additional intraoperative analgesia was administered for a 10% increase in heart rate, while postoperative pain was assessed using the Children\'s and Infants Postoperative Pain Scale (CHIPPS), with scores >4 prompting supplementary analgesia. Monitoring was extended for 24 h post-surgery. Results: CB significantly reduced the need for intraoperative (p < 0.001) and early postoperative (p = 0.008) analgesia compared to IINB. However, the CB group exhibited a slightly higher but non-significant analgesic requirement on the ward. No clinically relevant side effects were observed in either group. Conclusions: Both CB and IINB are effective and safe methods for providing regional analgesia during orchidopexy. CB demonstrates superior efficacy intraoperatively and in the early postoperative period, while IINB may offer advantages in the later recovery phase. However, additional analgesia is often required for orchidopexy, especially in outpatient settings.
摘要:
目的:这项前瞻性研究旨在比较尾神经阻滞(CB)和髂腹股沟/髂腹下神经阻滞(IINB)在单侧睾丸固定术中提供额外镇痛的疗效。方法:71名年龄<48个月的男孩,归类为ASAI/II,分为CB组(n=37)和IINB组(n=34)。结果测量包括术中和术后镇痛要求,疼痛评分,和管理持续时间。术中额外镇痛,心率增加10%,而术后疼痛使用儿童和婴儿术后疼痛量表(CHIPPS)进行评估,分数>4提示辅助镇痛。监测延长至术后24小时。结果:与IINB相比,CB显着降低了术中(p<0.001)和术后早期(p=0.008)镇痛的需求。然而,CB组对病房的镇痛需求略高,但无显著性.两组均未观察到临床相关的副作用。结论:CB和IINB都是在睾丸固定术中提供区域镇痛的有效且安全的方法。CB在术中和术后早期表现出优异的疗效,而IINB可能在后期恢复阶段提供优势。然而,睾丸固定术通常需要额外的镇痛,尤其是在门诊。