Comparison between Caudal and TAP Blocks Post-Inguinal Surgery Analgesia in Children

Abstract

Background: The optimal and lonely method to achieve typical analgesia post-inguinal surgeries in children is still not determined. This study compared the analgesic efficacy and adverse effects between caudal analgesia and TAP (Transversus Abdominis Plane) block. Methods: 40 children (male) between 3-9 years old, with parental consent and institutional board approval, undergoing elective inguinal hernia repair surgery, randomly divided in two groups were enrolled in this study. Both groups received induction on Sevoflurane, Fentanyl, Propofol and Atracurium (dose dependent), with laryngeal mask airway and mechanical ventilated, maintenance on Sevoflurane and smoothly recovered. The first group (C) received caudal analgesia of Bupivacaine 0.25% (1ml/kg). The second group (T) received TAP block of Bupivacaine 0.25% (0.5 ml/kg). Pain was assessed by CHEOPS (Children's Hospital of Eastern Ontario Pain Scale). Parents also assessed pain (after explain and orient them) with Wong-Baker scale 0 (no pain) and 10 (worst pain imaginable). Results: The first group (C) of patients had about 240 ± 30 minutes, while the second group (T) had about 360 ± 60 minutes, early ambulation and feeding and finally, most of them missed the pain till they were home discharged. Conclusion: TAP block enhances comfortable long-time post-op state for the patients, especially the young age group as they are hardly pain dealt off. Also TAP block has an easily performed procedure with less dose and complications compared to the caudal ones.