Comparative Study between Caudal Epidural Block and Ultrasound Guided Transversus Abdominis Plane Block for Post-Operative Analgesia in Children Undergoing Infraumblical Surgeries

Abstract

Background: Regional anesthesia techniques as a caudal epidural block (CEB) are commonly used to help with pain control during pediatric surgeries, decrease parenteral analgesics requirement, and improve the quality of postoperative pain control and general satisfaction of patient parents. Transversus abdominis plane (TAP) block is an evolving modality of regional anesthetic techniques for the abdominal wall. Objective: The aim of the current study was to compare the analgesic effect of CEB versus TAP block in pediatrics undergoing infraumblical surgeries. Patients and methods: A total of 120 kids between the ages of 4 and 7 years old who needed infraumbilical procedures were divided into two groups of 60 patients. Group (1) received caudal epidural block using Plain bupivacaine 0.25 % 1 ml/kg, and Group (2) received ultrasound-guided TAP block using plain bupivacaine 0.25% 1 ml/kg. Follow up postoperative pain using Faces Pain Scale-Revised, vital signs, first rescue analgesia, the total dose of paracetamol needed, and complications. Results: At 8 and 18 hours postoperatively, Group (1) had substantially lower pain scores on the Faces pain scale-revised, reduced heart rate and mean arterial pressure compared to Group (2). Group (1) had a considerably later time to first rescue analgesia with less paracetamol use than Group (2). There was no discernible difference in postoperative complications between groups (1) and (2). Conclusion: At 6-24 hours after block placement, caudal block provides superior analgesia compared to TAP block in children undergoing lower abdominal surgeries. Caudal block is an effective, feasible, and safe option for postoperative analgesia, especially when compared to TAP block.