Background: caudal epidural block (CEB) is the most preferred modality for pediatric regional analgesia because of its effective somatic and visceral pain control, though transversus abdominis plane (TAP) block is an evolving regional anesthetic technique for abdominal wall. Our study aims to compare the analgesic effect of (CEB) versus (TAP) block in pediatrics undergoing inguinal hernia repair surgeries.
Patient and Methods: The study enrolled 44 children, aged 3 to 7 years, scheduled for unilateral inguinal hernia repair surgery. Children were divided into 2 equal groups. Group A received ultrasound guided (CEB), while group B received ultrasound guided (TAP) block. We used a multimodal approach of pain control including regional block, intraoperative fentanyl when needed, standard postoperative paracetamol, and rescue ibuprofen when needed. Hemodynamic stability, fentanyl needs, time for first analgesic request, pain scores by Children's Hospital of Eastern Ontario Pain Score (CHEOPS), and ibuprofen requirements were recorded.
Results: Both (CEB) and (TAP) groups showed hemodynamic stability, meanwhile there was no need for fentanyl among all patients in both groups, and the time for first analgesia in CEB and TAP groups, was (4.59±0.59) and (7.48±1.35) hours respectively. Furthermore, the ibuprofen requirements and pain scores were statistically significantly higher in (CEB) group than (TAP) group (P-value < 0.05).
Conclusion: Both TAP block and CEB provide effective analgesia in children undergoing inguinal hernia repair surgery with TAP block superiority over CEB as evidenced by longer time for first analgesic request, decreased analgesics needs, and lower pain scores.
Keywords: caudal, TAP, ultrasound, pediatric, surgery.