Comparison between rectus sheath block with 0.25% ropivacaine and local anesthetic infiltration with 0.5% ropivacaine for laparoscopic inguinal hernia repair in children.

Comparison between rectus sheath block with 0.25% ropivacaine and local anesthetic infiltration with 0.5% ropivacaine for laparoscopic inguinal hernia repair in children. Nagoya J Med Sci. 2019 Aug;81(3):341-349 Authors: Tamura T, Kaneko K, Yokota S, Kitao T, Ando M, Kubo Y, Nishiwaki K Abstract This randomized, observer-blinded prospective study aimed to compare the postoperative analgesic effects of ultrasound-guided rectus sheath block with those of local anesthetic infiltration of the surgical field in children undergoing inguinal hernia repair. Children aged 2 to 14 years, scheduled for elective single-incision laparoscopic percutaneous extraperitoneal closure, were randomly allocated to receive ultrasound-guided rectus sheath block (group R) or local anesthetic infiltration of the surgical field (group L). In group R, 0.5 ml/kg of 0.25% ropivacaine (per side) was administered after intubation. In group L, 0.4 ml/kg of 0.5% ropivacaine was administered after peritoneal closure. Postoperative pain was assessed using the Face Scale and Face, Legs, Activity, Cry, Consolability scale at various time points, including the primary endpoint of 2 h after leaving the operation room. Additional analgesic drugs were used according to the Face Scale scores. Patient characteristics, the amount of additional drugs, and complication rate were evaluated in both groups. The patient and surgical characteristics were comparable between groups. The Face Scale and Face, ...
Source: Nagoya Journal of Medical Science - Category: International Medicine & Public Health Tags: Nagoya J Med Sci Source Type: research

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Eur J Pediatr Surg DOI: 10.1055/s-0040-1702222The surgical management of patients with congenital diaphragmatic hernia (CDH) is challenging and ever changing. It requires the highest expertise not only on the surgical level but also of neonatologists and anesthesiologists. In selected patients traditional open surgery is increasingly replaced by thoracoscopic CDH repair in many centers worldwide. Despite obvious and well-described advantages of the minimally invasive approach like a shorter ventilatory time, less pain, a shorter hospital length of stay, and a better cosmesis, important controversies remain. This review dis...
Source: European Journal of Pediatric Surgery - Category: Surgery Authors: Tags: Review Article Source Type: research
To introduce the use of a new surgical approach named single-incision bilateral inguinal herniorrhaphy (SBIH) in pediatric surgical population. This was a STROBE-compliant retrospective cohort study using data from 101 patients who had undergone bilateral inguinal herniorrhaphy in our institution. Children with bilateral inguinal hernias without contraindications for surgery, ranging in age from 6 months to 12 years, were included. Fifty-six children with bilateral inguinal hernias underwent SBIH (SBIH group) and 45 patients underwent laparoscopic bilateral inguinal herniorrhaphy (LBIH) (LBIH group). Differences in operat...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
POSTOPERATIVE PAIN AND STRESS RESPONSE: DOES CHILD'S GENDER HAVE AN INFLUENCE? Acta Clin Croat. 2019 Jun;58(2):274-280 Authors: Karišik M, Gligorović Barhanović N, Vulović T, Simić D Abstract Surgical procedure causes multisystem stress response reactions. The aim of this study was to assess whether gender has an impact on the level of neuroendocrine response to surgical stress and intensity of postoperative pain in children undergoing inguinal hernia repair surgery, as well as satisfaction of their parents with preoperative and postoperative care. The study included 60 children aged 3-6 yea...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
We present our experience with the use of an unilateral QLB to provide postoperative analgesia in a 3-year-old pediatric patient weighing 14 kg who underwent a unilateral inguinal hernia repair. His family was satisfied with the general status and pain cessation in the patient. PMID: 31736020 [PubMed - in process]
Source: Agri Dergisi - Category: Anesthesiology Tags: Agri Source Type: research
CONCLUSION: SIL is a laparoscopic technique that can safely be offered to patients presenting abdominal diseases. The main advantages include enhanced cosmetic results and reduced abdominal trauma. The main disadvantages are patient selection, a longer operative time for some procedures, and a need to expose the operative field for some other procedures. PMID: 31710087 [PubMed - in process]
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
Anesthetizing children with extreme cardiopulmonary illness can be especially challenging. In adults, a host of alternatives to general anesthesia for the labile patient are available, However, in children, these techniques may be challenging due to a lack of patient cooperation. Distraction techniques have been successfully used to reduce procedural pain. The patient whose case is reported here required surgery for inguinal hernia repair after repeated bowel incarceration. Due to severe end-stage cardiomyopathy, the risk of general anesthesia was deemed excessive. Distraction was used to usher the patient through an awake...
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
ConclusionAs PDH can lead to major and life threatening complications, it must remain in our minds as a possible cause of intestinal obstruction.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Conclusions and relevanceNo definite conclusions to decide on the superiority of one of either treatment strategies can yet be drawn from the available literature. There was evidence of substantial heterogeneity and the clinical relevance of most estimated effects is very limited.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
In this study, the researchers looked at opioid prescriptions in 2016, and the numbers are shocking. In the US, 22% of prescriptions written by dentists were for opioids, compared with just 0.6% for British dentists, and US dentists prescribed about 35 opioids per 1,000 population, compared to just 0.5 opioid prescriptions per 1,000 population in England. Additionally, the opioid prescribed in England was a relatively weak codeine-like drug, whereas in the US the majority of prescriptions were for hydrocodone, a stronger opioid with greater abuse potential. When does an opioid prescription make sense? It is simply impossib...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Addiction Pain Management Source Type: blogs
Abstract BACKGROUND: Perioperative anxiety is common in pediatric patients undergoing surgery. AIM: The aim of this study was to determine whether an infusion of dexmedetomidine prior to hernia repair in children provides better postoperative anxiety outcomes that a preoperative infusion of midazolam. METHODS: Ninety 6-11 year-old children, who were scheduled to undergo elective hernia repair, were enrolled for this double-blind, randomized controlled trial. Group D (n = 45) received an intravenous infusion of dexmedetomidine (0.5μg/kg) and Group M (n = 45) received an intravenous infusion of midazola...
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
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