Quadratus Lumborum Block versus Wound Infiltration for Pediatric Unilateral Inguinal Hernia Repair; A Prospective, Randomized Study

Abstract

Objective: The inguinal hernia repair has an important place among the lower abdominal surgeries regarding the daily pediatric surgery practice. This study was aimed to compare the postoperative analgesic effects of the surgical wound infiltration and transmuscular quadratus lumborum (TQL) in inguinal hernia surgery in the pediatric age group. Method: After ethical board approval was obtained, 50 patients between the ages of 2 months and 7 years undergoing elective unilateral inguinal hernia repair were randomized to TQL block (Group TQL, n=26) or to wound infiltration (Group 1, n=24). Group TQL received ultrasound-guided transmuscular quadratus lumborum block with 0.25% bupivacaine 0.5 ml/kg and Group I received wound infiltration with 0.25% bupivacaine 0.5 ml/kg before surgery. Pain scores (FLACC), parental satisfication, block complications and additional analgesia requirements were recorded. Results: It was determined a significant decrease in the FLACC pain scores in the TQL group for the rd (p<0.001) and 4th (p<0.05) hours compared to the infiltration group. However, there was no statistically significant difference between the groups for other time points (p>0.05). The paracetamol requirement was statistically lower in the Group TQL than Group I (6/20 vs 14/10 respectively, p=0.020). There was no statistically significant difference between groups for fentanyl consumption (p>0.05). There was no statistically significant difference between the groups regarding the parental satisfaction evaluation. Conclusion: In this study which evaluated TQL it has been reported that TQL provided effective analgesic activity in the first hours after surgery and decrease analgesic consumption. We believe that TQL is an analgesic solution alone compared to infiltration analgesia in pediatric inguinal hernia surgery.