Comparative Study between Intrathecal and Caudal Epidural Anesthesia in Children for Lower Abdominal Surgery

Abstract

Background: regional anaesthesia techniques are now established in the practice of pediatric anaesthesia. it is one of the most common techniques used for post-operative pain management in pediatric patients especially for urogenital, rectal, inguinal and lower extremity surgeries. Objective: to compare caudal and spinal anaesthesia in paediatrics regarding haemodynamics, efficacy (sensory block characteristics, motor block characteristics) post operative analgesia, surgeon’s satisfaction, parents’ satisfaction and complications incidence. Material and Methods: the present study was carried on100 patients, with age ranging from (6-12) and of ASA (american society of anaesthesia.) I, II classes undergoing infraubmliclal pediatric surgeries, patients in each group were randomly assigned to receive spinal or caudal epidural anaesthesia. Results: the demographic data of patients as regard age, sex and ASA classification showed no statistical significant difference between the two groups, where the study was designed to compare between the effectiveness of spinal anaesthesia with bupivacaine 0.3mg/kg and caudal anaesthesia with bupivacaine 2mg/kg(1ml/kg vol.) as a sole anaesthetic technique adequate for infraumblical pediatric surgeries below T10 as regard the sensory and motor block characteristics, perioperative haemodynamic effects, pain assessment, analgesic requirements, and both the surgeon ad parents satisfaction was assessed.the results showed the superiority of subarachnoid on achieving rapid onset of sensory blockade, intense motor blockade, on the other hand the caudal epidural had the advantage of longer post operative analgesic effect and lower post operative analgesic consumption, furthermore both techniques gained good degree of parent and surgeon satisfaction. Conclusion: if both techniques are correctly used and the anatomy of the patient is normal there is minimal risk of complications.