الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 109 |  |  |
| | | from | 109 | | |
Abstract
Background: Worldwide pediatric regional anesthesia continues to evolve. In some countries, regional anesthesia forms part of the anesthetic culture, however the use of regional anesthesia in children remains limited in some institutions because of the perception that the advantages of regional anesthesia over opiate analgesia does not worth the potential risks. Aim of the Work: to compare between intravenous fentanyl versus sacral epidural block versus ilioinguinal block in pediatric inguinal area surgery as regards their efficacy on the intraoperative and postoperative analgesic requirements. Patients and Methods: This prospective, randomized, comparative exploratory study was conducted in the Pediatric Surgery Unit, Ain Shams University hospitals by most expert, competent, senior staff anesthesiologist on 90 patients who were randomly allocated using sealed envelopes into 3 equal groups-30 patients each- to receive either intravenous fentanyl (group A) or sacral epidural block (group B) or ilioinguinal block (group C). Results: Anatomical landmark ilioinguinal, iliohypogastric nerve block, sacral epidural block and intravenous fentanyl are equally effective in controlling intraoperative and early postoperative pain, while caudal and ilioinguinal block provide longer postoperative analgesia when compared to intravenous fentanyl. Conclusion: the current study demonstrated that anatomical landmark ilioinguinal, iliohypogastric nerve block, sacral epidural block and intravenous fentanyl are equally effective in controlling intraoperative and early postoperative pain, While caudal and ilioinguinal block provide longer postoperative analgesia when compared to intravenous fentanyl in children aged 1-5 years old undergoing elective inguinal area surgery. Anatomical landmark ilionguinal/iliohypogastric nerve block has high failure rate when compared by ultraound technique which improve the success rate and prolong duration of postoperative analgesia. Recommendations: further studies on a larger scale of patients are needed to confirm the results obtained by present work, use of ultrasound to increase the success rate of ilioinguinal –iliohypogastric nerve block.