Ultrasound-Guided Transversus Abdominis Plane block versus Ultrasound-Guided Caudal Block for Pain Relief in Children Undergoing Lower Abdominal Surgeries

Abstract

Background: Transversus abdominis plane (TAP) block has been described as an effective technique to reduce postoperative pain intensity. Also, Caudal analgesia with local analgesics is effective but is often short-lived and associated with an undesired motor blockade and other complications. Objective: This prospective, randomized, controlled clinical study aimed to compare the effectiveness of analgesia by using ultrasound guidance for TAP block and caudal analgesia in children undergoing lower abdominal surgery. Patients and Methods: This prospective, randomized, controlled study included 60 children aged between 2 to 6 years, scheduled for elective lower abdominal surgery. Group A (n=20) received an ultrasound TAB block. Group B (n=20) received ultrasound-guided caudal block Group C (n=20) who was the controlled group received conventional analgesia. The intraoperative assessment included HR, systolic, diastolic and mean BP, need for rescue analgesia postoperative pain scores and parent satisfaction Results: No significant difference between all groups regarding demographic data, type and duration of surgery and intraoperative hemodynamic values. The control group had the highest number of patients and doses needed for rescue analgesia while TAB showed the lowest. The TAB group patient showed the highest degree of parent satisfaction than the other two groups. Conclusions: The study showed that TAB and Caudal block effective in postoperative pain-relieving in lower abdominal surgery in children however patients who received TAB block required less postoperative rescue analgesia with a better impact on pain scores than caudal block TAB show better parent satisfaction and earlier home discharge.