Effect of Bupivacaine with epinephrine wound instillation for pain relief after pediatric inguinal herniorrhaphy and hydrocelectomy

ABSTRACT

To evaluate the effect of a 20- or 60-second instillation period using 0.5% bupivacaine with epinephrine for pain relief after pediatric inguinal herniorrhaphy and hydrocelectomy. In a randomized, double blind study, 103 children [aged 1 to 12 years, American Society of Anesthesiologists [ASA] physical status 1 or II] were allocated into 4 groups after induction of anesthesia. Group 1 normal saline 0.25 mL/kg instilled, which remained in the wound for 20 or 60 seconds before wound closure. Group 2 0.25 mL/kg 0.5% bupivacaine with epinephrine 5 micro g/mL instilled, which remained in the wound for 20 seconds. Group 3 the same quantity and dose of drug 2 instilled as group, but remained in the wound for 60 seconds. Group 4 an ilioinguinal and iliohypogastric block performed before operation using 0.5 mL/kg 0.25% bupivacaine with epinephrine. The Children's Hospital of Eastern Ontario Pain Scale [CHEOPS] and Aldrete -Kroulik recovery scores were used to monitor postoperative pain and recovery status. Analgesic was given when the CHEOPS score was >/-7 despite other supportive therapy. -Children's hospital of Eastern Ontario pain score -Cry-none, moaning, crying, screaming,. -Facial-composed, grimace, smiling. -Verbal-none, other, pain, both, positive. -Torso-neutral, shifting, tense- shivering, upright, restrained. -Touch-none, reach, touch, grab, restrained. -Legs- neutral, squirming, drawn-up, standing, restrained