Journal of the West African College of Surgeons · 2025
Incidence of Complications and Parental Satisfaction Following Pain Relief Methods in Paediatric Herniotomy: Caudal Block Versus Pre-incisional Field Block and Diclofenac Suppository Approach.
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Kpalap Precious B, Usman Yohanna M, Aliyu Husseina A, Shaki Rimamkanati, Malau Kefas T, Nuhu Samuel I, Embu Henry Y, Isamade Erdoo S
Аннотация
INTRODUCTION: Acute post-operative pain is one of the most common adverse effects of surgery experienced by children following herniotomy. Methods of managing this adverse effect include the use of caudal block, pre-incisional field block, and parenteral analgesics. We therefore sought to determine the incidence of complications and parental satisfaction following caudal block versus combination of pre-incisional field block and rectal diclofenac suppository for post-herniotomy analgesia.
MATERIALS AND METHODS: This was a randomised single-blind controlled clinical trial carried out in the Modular theatre of the Jos University Teaching Hospital. Fifty-eight children aged 1-6 years scheduled for elective day case open unilateral inguinal herniotomy with an American society of anesthesiologists of I and II were recruited and randomised into groups A and B; 1 mL/kg of 0.25% plain bupivacaine was administered caudally to group A, while 1 mL/kg of 0.25% plain bupivacaine and 1 mg/kg of diclofenac suppository were administered via pre-incisional field block to group B. Presence of complications such as nausea, vomiting, and pain was noted. Parental satisfaction with post-operative analgesia was assessed using a 5-point Likert item. Data collected were analysed using the SPSS.
RESULTS: Patients in the two study groups were comparable with respect to the measured parameters. Two (6.9%) patients in the caudal block group experienced vomiting, while three (10.3%) patients in both study groups had hypotension. Twenty-six (89.7%) and 19 (65.5%) parents in the caudal block group and field block with diclofenac suppository group were, respectively, "very satisfied" (P = 0.0001). No parent was either dissatisfied or extremely dissatisfied.
CONCLUSION: Both caudal block with plain bupivacaine and pre-incisional field block with plain bupivacaine plus diclofenac suppository showed comparable efficacy in the incidence of minimal complications. No parent was either dissatisfied or extremely dissatisfied with the techniques.
MATERIALS AND METHODS: This was a randomised single-blind controlled clinical trial carried out in the Modular theatre of the Jos University Teaching Hospital. Fifty-eight children aged 1-6 years scheduled for elective day case open unilateral inguinal herniotomy with an American society of anesthesiologists of I and II were recruited and randomised into groups A and B; 1 mL/kg of 0.25% plain bupivacaine was administered caudally to group A, while 1 mL/kg of 0.25% plain bupivacaine and 1 mg/kg of diclofenac suppository were administered via pre-incisional field block to group B. Presence of complications such as nausea, vomiting, and pain was noted. Parental satisfaction with post-operative analgesia was assessed using a 5-point Likert item. Data collected were analysed using the SPSS.
RESULTS: Patients in the two study groups were comparable with respect to the measured parameters. Two (6.9%) patients in the caudal block group experienced vomiting, while three (10.3%) patients in both study groups had hypotension. Twenty-six (89.7%) and 19 (65.5%) parents in the caudal block group and field block with diclofenac suppository group were, respectively, "very satisfied" (P = 0.0001). No parent was either dissatisfied or extremely dissatisfied.
CONCLUSION: Both caudal block with plain bupivacaine and pre-incisional field block with plain bupivacaine plus diclofenac suppository showed comparable efficacy in the incidence of minimal complications. No parent was either dissatisfied or extremely dissatisfied with the techniques.