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    Ilioinguinal and Iliohypogastric Nerve Blocks in Children
    (Mongolian National University of Medical Sciences, 2017-02-25) ;
    Maygmar, Ariuntungalag
    ;
    Ayurzana, Ganchimeg
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    ;
    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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    Ultrasound-Guided Unilateral Posterior TAP Block for Lower Abdominal Surgery in Children
    (Mongolian National University of Medical Sciences, 2021-09-14) ; ;
    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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    Comparison of Local Infiltration Analgesia With Femoral Nerve Block for Pain Treatment Outcome of Total Knee Arthroplasty
    (Mongolian National University of Medical Sciences, 2016-11-25)
    Khuvtsagaan, Bayalagmaa
    ;
    Maidar, Otgonbayar
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    Sodnompil, Dashtsogt
    ;
    Myagmarsuren, Temuulen
    ;
    Altangerel, Nergui
    Objectives: This retrospective study compared local infiltration analgesia (LIA) with femoral nerve block (FNB) after total knee arthroplasty (TKA). The aim of the study was to investigate the effect of LIA and FNB, measuring the primary outcome by fentanyl consumption, the secondary outcome by pain scores, and the tertiary measure by postoperative nausea and vomiting incidences. Methods: In this retrospective study, medical history records of 99 TKA patients were reviewed from 2 groups: (1) the LIA group was injected with 180 mg of ropivacaine to the wound and (2) the FNB group was treated with FNB with ropivacaine and morphine. All patients received fentanyl-based patient controlled analgesia (PCA). The observation of outcomes was done during 24 hours. Results: No difference was detected between two groups on the first postoperative day, and the bolus fentanyl consumption was significantly higher in the LIA group. All recorded visual analog scale (VAS) scores both at rest and with movement were similar at 1-12 hours, but at 13-24 hours VAS scores at rest were significantly less in the FNB group. Postoperative nausea and vomiting incidences were significantly different between the two groups. Conclusion: Single shot LIA with ropivacaine reduces the early pain after unilateral TKA. FNB can provide longer analgesia than LIA.