Comparison of preoperative and postoperative analgesic properties of ilioinguinal/iliohypogastric and sacral block in pediatric unilateral inguinal hernia operations

The aim of this study is to evaluate preoperative and postoperative analgesic properties of ilioinguinal/iliohypogastric and sacral block for inguinal hernia operations.The study evaluated 60 patients aged between 1-8 in ASA risk group I-II, after written aprooval of parents. Patients were divided into two groups equally. After reaching an adequate anesthethical state/depth with 8 % sevoflurane in 50 % O2 + 50 N2O induction, appropriate LMA for their age and weight was placed. Patients were monitored with standard methods and fluids were given with a dose of 10 mL/kg iv. For group S, patient has been positioned as lateral decubitus and were received 0.7 mL/kg epidural (20 mL max.), 0.25 % bupivacaine at the S2-3 level , for group i, patient has been in supin position and were received 0.7 mL/kg epidural, 0.25 % bupivacaine with peripheral block needle blunt type of the needle at the 2 cm medial and 2 cm cranial with respect to anterior superior iliac spine as the double pop technique. Patients were maintained with 40 % O2 and 60 % N20 with 1.2 MAC Sevoflurane about 10 minutes. N20 shutted down and medical air has been used 10 minutes after 2 blocks. MAC Sevoflurane decreased to 0.7. Intraoperative HR, SAP, DAP, MAP, MAC Sevoflurane values and postoperative APDS and CHEOPS scores were recorded. It was read as inadequate analgesia that HR and SAP values has increased 20 % above control value during operation and APDS?5 and CHEOPS?10 after operation so it was planned to give patient N20 instead of medical air during operation and to give patient fentanyl and paracetamol after operation.There were no significant differences in HR and blood suger paramaters among groups got similar definitive characteristics during operations but it was observed that there is a significant decreasing in SAP, DAP, MAP of group S and MAC Sevoflurane significant decreasing in group I. There was provided adequate analgesia for all patients in both groups during operation. There were no significant differences among groups about postoperative analgesia periods. Patients from IL/IH nerve block group (group I) need for less additive analgesia at 8th hour and 12th hour over 24 hour period. CHEOPS scale gave more positive results than APDS scale in same time shares. But the positive results were not correlated with additive analgesia. It is convinced that the differences in results of scales are related to emotional questions of CHEOPS and one is not superior to other.As a result, IL/IH nerve block can be safely used in inguinal operations that effect a common dermatoma like inguinal hernia, cord cyst and hydrosel since the risk of motor block is minimal in terms of peroperative and postoperative analgesy and it?s easier to apply compared to epidural and caudal block.