Comparison of Caudal Epidural Block and Ultrasound Guided Transversus Abdominis Plane Block For Pain Relief In Children Undergoing Lower Abdominal Surgery

Caudal epidural block is the most commonly performed regional block in paediatric anaesthesia for providing intraoperative and postoperative analgesia after lower abdominal and perineal surgeries. Although the efficacy and safety of this technique is high, it has certain disadvantages such as unwarranted motor blockade of the lower limbs and disturbance of bladder function.The limitation of caudal block when administered  as a ‘single- shot technique’ is its limited duration of action, about 4-6 hours post block, making administration of additional pain medicine necessary.

Peripheral nerve blocks are alternative to caudal block with a lower incidence of side effects and a prolonged duration of analgesia. The nerves that supply the abdominal wall (T7-L1) course through the neurofascial plane between the internal oblique and the transversus abdominis muscle. The blockade of nerves in this location is known as the transversus abdominis plane block (TAP block). Ultrasound guided technique improves the margin of safety due to better localization and deposition of local anaesthetic with improved accuracy. Ultrasound guided transversus abdominis plane (TAP) block has been described in children undergoing lower abdominal and laparoscopic surgery. However, there are only few randomized clinical trials regarding use of ultrasound guided TAP block in children.

In the present study we want to compare the efficacy of ultrasound guided transversus abdominis plane (TAP) block and caudal block for providing postoperative pain relief in children undergoing lower abdominal surgeries.xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /