The purpose of this study was to compare the effects of ilioinguinal/iliohypogastric (IG/IH)
nerve block and intravenous
fentanyl for
pain control following inguinal
herniorrhaphy in pediatric outpatients. Seventy-five ASA physical status I and II children (aged 1 to 10 yr) with unilateral inguinal
herniorrhaphy under
general anesthesia were randomly divided into three groups. Group A received IG/IH
nerve block, using 0.25%
bupivacaine (1 mg/kg) immediately after induction. Group B received intravenous
fentanyl (1 microgram/kg) immediately after induction. Group C received only
general anesthesia as control. At postanesthetic care unit (PACU), we recorded the degree of
pain/or discomfort at 5, 15, 30, 45 and 60 min using modified Hannallah's scoring system after the patient was fully awake. The degree of recovery was also evaluated using Steward's scoring system. After discharge, the parents were interrogated about the condition of child within 24 h by telephone. Follow-up items raised included
vomiting, drowsiness,
pain and shivering. Our results showed that children in both study groups had lower
pain score than those in the control group, and in the
fentanyl group children had lower
pain score than in the
nerve block group during the first 30 min at PACU. The recovery time was also longer in the
fentanyl group. There was no significant difference among the three groups regarding the raised items over telephone interrogation. In sum, inguinal
nerve block was effective for
postoperative pain relief in children undergoing inguinal herniorraphy. We also suggested that small dose of intravenous
fentanyl would serve as an easy, simple and effective means for relieving postinguinal
herniorrhaphy pain during the first 30 min of the initial postoperative period.