Comparison of Analgesic Efficacy of Ultrasound-Guided Transversus Abdominus Plane Block and Caudal Block for Inguinal Hernia Repair in Pediatric Population: A Single-Blinded, Randomized Controlled Study.

BACKGROUND

Caudal analgesia was a widely practiced regional anesthesia technique in pediatric population. Transversus abdominus plane block (TAP) block has recently emerged as a promising analgesic method in pediatric lower abdominal surgeries.

AIM

This study aimed to compare the analgesic efficacy of ultrasound-guided TAP block and caudal block.

SETTING

This study was conducted in the department of anesthesiology of a tertiary care teaching hospital.

DESIGN

This was a prospective, single-blinded, randomized controlled study.

MATERIALS AND METHODS

Sixty-two children of American Society of Anesthesiologists Class I and II undergoing inguinal hernia repair received TAP block at a dose of 0.5 ml.kg of 0.25% bupivacaine (Group A) or caudal block at a dose of 1 ml.kg of 0.25% bupivacaine (Group B) after randomization. The children were analyzed by comparing the post operative pain scores and duration of analgesia. Statistical analysis was done with IBM SPSS software 23 version. Unpaired sample -test and Mann-Whitney U-test were used to compare the means of continuous variables. Fisher's exact test/Chi-square test was used to find the association between categorical variables.

RESULTS

Both groups were comparable in terms of age, gender, weight, and surgery duration. Duration of analgesia was longer in TAP block group compared to that of caudal analgesia (12.93 ± 2.91 h vs. 6.52 ± 1.67 < 0.001). The postoperative pain scores were comparable up to 6 h and at 24 h. Pain scores at 12 h and 18 h were significantly higher in caudal analgesia group compared to that of TAP block group.

CONCLUSION

Children who received TAP block had prolonged duration of analgesia and lower pain scores compared to those who received caudal analgesia.