Болдбаатар, Одгэрэл

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Pediatric anesthesia in Mongolia and Thailand
(Wiley, 2024-09)
Charoenraj, Pornarun
;
Chinzorig, Zolzaya
;
Adiya, Dolgorsuren
;
Aroonpruksakul, Naiyana
;
Ayatkhan, Khuanysh
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Ultrasound-Guided Unilateral Posterior TAP Block for Lower Abdominal Surgery in Children
(Mongolian National University of Medical Sciences, 2021-09-14)
Odgerel Boldbaatar
;
Ganbold Lundeg
;
Sergelen Orgoi
Objectives: This study aimed to evaluate the analgesic effect of ultrasound-guided transversus abdominis plane block in children. Methods: Children between 3-18 years of age on whom lower abdominal surgeries were preformed are included in this random control trial (RCT). The parents signed a written consent form. Patients were randomized into control and study groups. Every group was divided into subgroups either with or without inflammation. Results: There were no differences between the two studied groups regarding demographic and clinical characteristics. Hemodynamics were more stable in the study group than in the control group. After induction, BP decreased in all groups and increased after surgical incision except for the transversus abdominis plane elective (TAP + Elec) group. An elevated white blood cell count was used as the mean indicator of inflammation. The opioid usage during the operation was significantly different in the subgroups (p = 0.000). The relationship between WBC and opioid usage was weak, positive, and statistically significant. Postoperative pain and pain medication requirements were lower in the TAP block group. Conclusion: Transversus abdominis plane block under ultrasound guidance is easy, safe, reliable, and adequate for analgesia in children. This method can decrease surgical and postoperative pain and analgesic requirements.
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Ilioinguinal and Iliohypogastric Nerve Localization in Children: Our Initial Ultrasound Investigation
(2022-02-26)
Odgerel Boldbaatar
;
Ganbold Lundeg
;
Sergelen Orgoi
Objective: The purpose of our study is to examine the localization of the Ilioinguinal and Iliohypogastric (ILIH) nerves by using ultrasound and its relationship to age, BW in children. Methods: Children between 1-16 years of age, ASA I-II class, admitted to the surgical department for inguinal hernia, orchidopexy, and hydrocele repair were included in this prospective, randomized study at the National Center for Maternal and Child Health of Mongolia. We divided these children into three age groups: 1-4 years, 5-8 years, and more than 9 years old. The transducer was placed longitudinally at the line drawing from the ASIS to the umbilicus and after identifying the ILIH nerves we measured the distances of the anatomical structures: depth or thickness of the abdominal anterior wall structures and distance of ILIH nerves from the ASIS. When we identified the ILIH nerves we saved the pictures in the US machine. Identification and visibility scores of nerves and muscles were made by using a Likert scale and Vienna score and showed in the median. We recalled the data and analyzed it with repeated measurements, followed by ANOVA for a single factor. The correlation was calculated using the Pearson’s correlation coefficient. The tables show a mean ±SD and number (%) of subjects. A p-value<0.05 was considered statistically significant. Results: A total of 55 pictures were analyzed. The current study showed that the distance and depth of some anatomical structures, such as the mean distance of skin-peritoneum was 1.43±0.37 cm (CI 95% 0.76-2.37, p=0.0023), the thickness of internal oblique muscle was 0.33±0.14 cm (CI 95% 0.11-0.75, p=0.0022), the target point of ILIH nerve which was equal to the skin to TAM distance 1.06±0.3 cm (CI 95% 0.56-1.82, p=0.0093) were increasing regarding the age. For other measurements of depth not seen age-related statistically significant differences. According to the location of the ILIH nerves to the ASIS, in younger children they locate more close than in bigger children, however, only the distance of ASIS-IHN was statistically significant. The ILIH nerves localize more close to the iliac bone in the younger children and when age is increasing the nerve locates more medially and it correlates to the BW and ages. Conclusion: ILIHN were visible by ultrasound in children. ILHN location correlates to age, BW, and BMI.
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Ilioinguinal and Iliohypogastric Nerve Blocks in Children
(Mongolian National University of Medical Sciences, 2017-02-25)
Boldbaatar, Odgerel
;
Maygmar, Ariuntungalag
;
Ayurzana, Ganchimeg
;
Lundeg, Ganbold
;
Orgoi, Sergelen
Objectives: To examine ilioinguinal and iliohypogastric (ILIH) nerve block techniques among children. Methods: A total of 120 children, aged 1-16 years, were included in this prospective, randomized, single-blinded study. Children received an ILIH nerve block using the conventional fascial click of double “pop” technique on four different points: (Group I, n=30) ILIH block at the junction of the lateral one-fourth, the medial three-fourth in the line from the anterior superior iliac spine (ASIS) to the umbilicus; (Group II, n=28) approximately 2.5 mm medial to the ASIS; (Group III, n=30) 10 mm medial-superior to the ASIS; and (Group IV, n=30) 10mm medial-inferior to the ASIS. Intraoperative hemodynamic changes, postoperative pain intensity, time of first analgesic requirement, and correlation between BMI and groups were examined. Results: The average pain score 2 hours after operation was lowest in group I (1.04±1.23 [Cl 95%, 0-5.3]) and highest in group IV (2.88±2.47 [Cl 95%, 0-9]), a difference of statistically significance (p=0.0027). In group I only, the pain intensity had a weak, positive correlation with BMI (r=0.49, p=0.006). Conclusion: Group I used the best ILIH block technique.

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