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Comparison of the effect of Mini-Bier's Block using Ketamine and Lidocaine on Propofol Injection pain in Children Aged 3-8 Undergoing Inguinal Hernia Surgery
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| Author:
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ALIREZA TAKZARE, MEHRDAD GOUDARZI, ANAHID MALEKI, FAHIMEH BORJIKHANI, MEHDI SANATKAR
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| Abstract:
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Objective: Propofol is a safe and effective anesthetic commonly used in pediatric surgeries. However, pain on
propofol injection is the most important problem associated with its pediatric use. Reducing pain on propofol
injection has beneficial effects on induction of anesthesia.
Materials and methods: In this study, sixty 3-8 year-old ASA I children and two candidates for elective inguinal hernia
surgery were assigned to three groups. In the first group, the tourniquet was tied and 10 mg of ketamine in a 1 ml
solution was injected in 30 seconds. Then, the tourniquet was untied and propofol was used to induce anesthesia. 1
ml of lidocaine 2% w/v and 1 ml of 9% normal saline was injected in the second and third groups, respectively. Ten
seconds after propofol injection, the occurrence of pain was assessed on the Cameron Scale and was determined to
be 0-3 across all groups. Agitation, nausea, and vomiting during recovery were recorded and statistically analyzed.
Results: There were no significant differences between the study groups in terms of such demographic variables as
age and sex, and the subjects in all three study groups had a mean age of 5 years. Pain on propofol injection was 1.4
on average in the studied patients. The average pain intensity was 0.7, 1.3, and 2.2 in the ketamine, lidocaine, and
control groups, respectively. Considering a p-value of 0.00, this difference was significant. In terms of hemodynamic
changes, statistical analysis indicated a significantly lower blood pressure drop in the ketamine group compared to
the other groups (p=0.00). The average satisfaction rate of recovery nurses was 4.1 in the ketamine group, 3.75 in the
lidocaine group, and 2.75 in the control group (p=0.00). Statistical analysis did not show a significant difference
between groups in terms of occurrence of nausea. The average length of stay in the studied patients was 44.88
minutes, with no significant difference between groups in length of stay in recovery (p=0.144).
Discussion and Conclusion: This study found the reduction of pain intensity to be in the following order: Ketamine>
Lidocaine> Normal Saline. Also, ketamine provided greater cardiovascular stability than the other two drugs. Nurses
were most satisfied with the ketamine group, which leads to the conclusion that the patients who received ketamine
were more relaxed during recovery.
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| Keyword:
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Propofol, ketamine, inguinal hernia, pediatrics, lidocaine
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| DOI:
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