Pain response to laparoscopic inguinal hernia repair in newborns and infants using different anesthetic modalities.

Abstract

Recently, a monitor called the Newborn Infant Parasympathetic Evaluation (NIPE) has been used to study pain in children under 2 years of age, as it assigns a numeric value to the pain response. It does this by analysing the variability of the heart rate, and studies have shown that it accurately tells us when the child is reacting to pain during surgery.

For many surgeries, laparoscopic (key-hole) approaches are becoming more widely used. However, this is limited research investigating pain in laparoscopic inguinal hernia repair surgeries. We recently conducted a small study that showed that the addition Local Infiltration (anaesthetic injected into the area being operated on) may reduce pain in comparison with Caudal Block (anaesthetic injected into the base of the spine) alone.

Therefore, our study aims to compare differences in pain during and after laparoscopic inguinal hernia surgery between children who receive local infiltration and children who receive caudal blocks, using the NIPE monitor.

If this study is effective, it will potentially allow us to better prevent children from experiencing pain after surgery, by balancing the anaesthetic and pain medications in a more focussed way. It will also potentially clarify if one of the anaesthetic methods is associated with reduced pain during and after surgery.