[Comparison among three techniques of postoperative regional analgesia with ropivacaine in children.].

BACKGROUND AND OBJECTIVES Postoperative pain increases cost and generates dissatisfaction among parents regarding to the analgesics prescribed to their children. Ropivacaine has a broad safety margin to be used for regional block in pediatric patients. The aim of this study was to compare caudal epidural block (CE) with ilioinguinal/iliohypogastric nerve block (IINB) and infiltration of surgical wound (ISW) with ropivacaine for postoperative analgesia in children. METHODS Eighty-seven children, all males, ages 1 to 5, who underwent elective unilateral inguinal herniorrhaphy participated in this study. Children were randomly assigned to receive CE, IINB, or ISW. The need for postoperative analgesia, length of time until the first dose, severity of pain, and degree of the motor blockade were evaluated. RESULTS The need for analgesia and pain severity in the first two hours were greater for the ISW Group when compared with the CE and IINB Groups. Only the children in the CE Group presented a mild motor blockade. The mean length of time until de 1st dose of analgesic was similar in all groups. CONCLUSIONS Ilioinguinal/iliohypogastric nerve block was superior to ISW, especially in the first two hours after the surgery. The three anesthetic techniques can be safely and effectively used to control postoperative pain in inguinal herniorrhaphy in children.