Efficacy of caudal block versus rectus sheath block forpostoperative analgesia in children undergoing umblical hernia repair: Randomized controlled study

Abstract

Background Umbilical hernia repair, a common day-case surgery in children, is associated with postoperative discomfort. Different modes of postoperative analgesia for umbilical hernia repair had been used, such as rectus sheath block (RSB) and caudal block (CB). Aim The aim of this study is to improve the quality of postoperative analgesia and decrease pain score and analgesia requirement for pediatric patients undergoing umbilical hernia repair using ultrasound (US)-guided RSB. Patients and methods A total of 60 patients undergoing elective umbilical hernia repair were allocated randomly into two groups: US-guided RSB (group A) and CB (group B). All patients received the same general anesthetic technique. In group A, bilateral US-guided RSB was performed using 0.25% bupivacaine at 0.25 ml/kg. In group B, CB was performed using 0.25% bupivacaine at 1 ml/kg. Postoperative analgesia using a modified Children’s Hospital of Eastern Ontario Pain Scale and total amount of postoperative paracetamol requirement as rescue analgesia were recorded. Results There were significant decrease in pain score in group A than group B at 2, 4, 6, and 8 h postoperatively, with P=0.0001, 0.0357, 0.0095, and 0.0249, respectively. The mean value of paracetamol consumption is significantly reduced in group A, with mean value of 444 mg, in comparison with group B at 718.83 mg. Conclusion US-guided RSB can be considered a good alternative to CB in analgesia of postoperative pain after umbilical hernia repair in pediatrics.