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Comparison of Ultrasound Guided Transversus Abdominis Plane Block and Caudal Epidural Block for Pain
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Context: Transversusabdominis plane block (TAP) has emerged as a simple, safe technique for post-operative analgesia in lower abdominal surgeries for adults. Its superiority over the most preferred caudal block in paediatric surgeries is unclear. Aims: To evaluate the efficacy of the Ultrasound (USG) guided -TAP block in comparison with the Caudal Block, for pain relief in paediatricinguinal herniotomies. Settings and Design: After obtaining institutional ethical committee approval, a Randomised Control Trial was conducted in 60 children,undergoing elective unilateral inguinal herniotomy in our tertiary care hospital. Methods and Material: Childrenof age 1 7years, weighing 5-20kg of ASA I/II were randomly allocated into two groups after obtaining parental consent.Group T received USG-guided TAP block (0.5ml/kg of 0.25% bupivacaine) and Group C received Caudal block (1ml/kg of 0.25% bupivacaine). The intra-operative hemodynamics and analgesic requirement were recorded. Pain in the post-operative period was assessed using FLACC pain score. Time to first rescue analgesia, cumulative opioid consumption, along with the incidence of side effects were noted in the first 12hrs of the post operative period. Statistical analysis was performed using SPSSv16. Results: The duration of postoperative analgesia in Group T (8.6hrs±1.84), was significantly more than that of Group C, (4.57hrs±1.406). The pain scores and the mean opioid consumption were significantly less with Group T. Time to urine voiding was prolonged in Group C. Conclusions: ThoughCaudal block provided better intra-operative analgesia; the duration of post operative analgesia was longer with USG-guided TAP block for pediatric inguinal herniotomy.
Perspectives
Context: Transversusabdominis plane block (TAP) has emerged as a simple, safe technique for post-operative analgesia in lower abdominal surgeries for adults. Its superiority over the most preferred caudal block in paediatric surgeries is unclear. Aims: To evaluate the efficacy of the Ultrasound (USG) guided -TAP block in comparison with the Caudal Block, for pain relief in paediatricinguinal herniotomies. Settings and Design: After obtaining institutional ethical committee approval, a Randomised Control Trial was conducted in 60 children,undergoing elective unilateral inguinal herniotomy in our tertiary care hospital. Methods and Material: Childrenof age 1 7years, weighing 5-20kg of ASA I/II were randomly allocated into two groups after obtaining parental consent.Group T received USG-guided TAP block (0.5ml/kg of 0.25% bupivacaine) and Group C received Caudal block (1ml/kg of 0.25% bupivacaine). The intra-operative hemodynamics and analgesic requirement were recorded. Pain in the post-operative period was assessed using FLACC pain score. Time to first rescue analgesia, cumulative opioid consumption, along with the incidence of side effects were noted in the first 12hrs of the post operative period. Statistical analysis was performed using SPSSv16. Results: The duration of postoperative analgesia in Group T (8.6hrs±1.84), was significantly more than that of Group C, (4.57hrs±1.406). The pain scores and the mean opioid consumption were significantly less with Group T. Time to urine voiding was prolonged in Group C. Conclusions: ThoughCaudal block provided better intra-operative analgesia; the duration of post operative analgesia was longer with USG-guided TAP block for pediatric inguinal herniotomy.
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This page is a summary of: Comparison of Ultrasound Guided Transversus Abdominis Plane Block and Caudal Epidural Block for Pain Relief in Children Undergoing Unilateral Inguinal Herniotomy, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.5118.7.
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