الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
In recent years, awareness of the value of adequate postoperative pain relief has been increased and several methods have been introduced. An effective pain therapy to block or modify the physiologic responses to stress has become an essential component of modern paediatric anaesthesia.
Ultrasound guidance for regional anaesthesia is associated with higher block success rates, shorter onset times, and reduced total anaesthetic dose required and reduced complications. There is also the advantage of direct observation of the pattern of anaesthetic spread.
This study was carried out to evaluate the postoperative analgesia of preincisional ultrasound guided bilateral rectus sheath block (BRSB) versus local anaesthetic wound infiltration (LAI) after paediatric umbilical hernia repair.
This study was carried out in Paediatric Surgery Department in El-Shatby Hospital on 48 children of both sex aged (1-8 years) evaluated as American Society of Anesthesiologists (ASA) I or II physical status undergoing elective umbilical hernia repair.
Patients were randomly assigned via closed envelope technique into two equal groups 24 children each:
group I: patients received preincisional ultrasound guided bilateral rectus sheath block with bupivacaine 0.25% (0.5 ml/kg).
group II: patients received bupivacaine 0.25 %( 0.5 ml/kg) subcutaneous at the surgical site after the repair.
All the patients were assessed pre-operatively by detailed history taking, complete clinical examination and routine laboratory investigations.
On arrival to the operating room, patients were monitored using an electrocardiograph, a non-invasive arterial blood pressure monitor and pulse oximeter.
They were all pre-medicated using midazolam at 0.5 mg/kg with a maximum 5mg 10-30 minutes before surgery then subjected to the same anaesthetic protocol.
All patients received a standardized general anaesthetic technique using fentanyl (1-2 µg/kg) IV, followed by laryngeal mask airway (LMA) was inserted and anaesthesia was maintained with oxygen and sevoflurane 2-3% delivered via an Ayre’s T-piece with spontaneous ventilation.
Haemodynamic measurements (including the heart rate, mean arterial blood pressure, and the percentage of oxygen saturation), postoperative pain using FLACC, duration of analgesia, and total dose of supplementary analgesic in the first 12 hours postoperatively, duration of surgery and side effects were recorded and statistically analysed.