Comparison of Bupivacaine Wound Infiltration with Bupivacaine Caudal Block on Postoperative Pain in Pediatric Open Inguinal Herniotomy

Abstract

Objective: To compare the effectiveness of Bupivacaine local wound infiltration with Bupivacaine caudal block on postoperative pain in children undergoing open inguinal hernia repair.

Study Design: Quasi-experimental study.

Place and Duration: Department of Paediatric Surgery, Pak Emirates Military Hospital Rawalpindi, from Jan to Sep 2019.

Methodology: 60 patients (30 each in two groups) fulfilling the inclusion criteria who underwent open inguinal herniotomy were included in this study. Patients in group-A received caudal block with 0.25% Bupivacaine 1 ml/kg body weight, while Group-B received local wound infiltration of 0.5% Bupivacaine 2 mg/kg body weight after the completion of surgery. The post-operative pain score was calculated using Hannallah's objective pain scale at 30 minutes, one, two, four, six and eight hours following the procedure. A total pain score of 3 requiring the rescue analgesia in the form of oral Paracetamol (10 mg/kg body weight) was considered the endpoint.

Results: Mean post-operative pain score was 8.20 ± 1.54 in group-A compared to 7.20 ± 1.88 in Group-B with the p-value of 0.02, which showed a statistically significant difference between the two groups.

Conclusion: We concluded that local infiltration with Bupivacaine after open herniotomy in children is safe, highly effective and easy to perform the procedure, which results in excellent post-operative analgesia compared to caudal Bupivacaine block.