Document Detail

The relative position of ilioinguinal and iliohypogastric nerves in different age groups of pediatric patients.
MedLine Citation:
PMID:  20236097     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Ilioinguinal nerve (IIN) and iliohypogastric nerve (IHN) blocks provide good perioperative pain relief for children undergoing inguinal procedures such as inguinal hernia repair, orchiopexy, and hydrocelectomy. The aim of this ultrasound imaging study is to compare the relative anatomical positions of IIN and IHN in different age groups of pediatrics. METHODS: Two-hundred children (aged 1-82 months, ASA I or II) undergoing day-case surgery were consecutively included in this study. Following the induction of general anesthesia, an ultrasonographic exam was performed using a high-frequency linear probe that was placed on an imaginary line connecting the anterior superior iliac spine (ASIS) to the umbilicus. RESULTS: There were significant differences in ASIS-IIN (distance from ASIS to IIN), ASIS-IHN (distance from the ASIS to the IHN), and IIN-IHN (distance between IIN and IHN) between the age groups: <12 months (n=84), 12-36 months (n=80), and >37 months (n=36). However, IIN-Peritoneum (distances from IIN to peritoneum), skin-IIN, and skin-IHN (depth of IIN and IHN relative to skin) were similar in three groups. ASIS-IIN and ASIS-IHN showed significantly positive correlations with age. CONCLUSIONS: Age should be considered when placing a needle in landmark techniques for pediatric II/IH nerve blocks. However, needle depth should be confirmed by the fascial click due to the lack of predictable physiologic factors.
J-Y Hong; W O Kim; B N Koo; Y A Kim; Y Y Jo; H K Kil
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Publication Detail:
Type:  Journal Article     Date:  2010-03-10
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-07-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  566-70     Citation Subset:  IM    
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
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MeSH Terms
Abdominal Wall / innervation*,  ultrasonography
Age Factors
Body Weights and Measures
Child, Preschool
Hypogastric Plexus / anatomy & histology,  ultrasonography*
Ilium / innervation
Inguinal Canal / innervation
Nerve Block / methods
Peripheral Nerves / anatomy & histology,  ultrasonography*
Pubic Bone / anatomy & histology,  ultrasonography*
Surgical Procedures, Elective
Umbilicus / anatomy & histology*,  ultrasonography

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