Ultrasound-Guided TAP Block versus Ultrasound-Guided Caudal Block for Postoperative Analgesia in Pediatric Lower Abdominal Surgery: A Prospective Randomized Study

In day care pediatric surgical units, lower abdominal operations such as herniotomy, appendectomy, and undescended testis are regularly performed. They are linked to considerable postoperative pain and discomfort. The purpose of this study is to compare post operative analgesic effectiveness of ultrasonography-guided caudal epidural block (USG CEB) versus ultrasonography-guided transverses abdominis plane (USG TAP) block in pediatric patients undergoing lower abdominal surgery. Forty patients undergoing lower abdomen surgery were randomly divided to two equal groups using sealed opaque envelopes: TAP group utilizing TAP block and caudal group using caudal epidural block. We compared the two groups in terms of total analgesia consumption in 24 hours, postoperative analgesia using Numeric Rating Scale (NRS-11), time to first rescue analgesia, and problems related to method or drugs employed. The TAP Group was statistically highly significant(p-value<0.001), less as regard total postoperative analgesic consumption than the Caudal Group until 12 hours after surgery, there was not statistically significant(p-value>0.05) difference between the two groups. However, 18 hours postoperatively, the caudal group had a greater NRS-11 than the TAP group. Need of analgesia was statistically significantly (p-value 0.003) faster in Caudal Group compared to TAP Group according to timing of first rescue analgesia. There was a statistically significant(p-value<0.05) difference between groups according to complication related to technique or drug used regarding delayed micturition and Motor block with higher complications in caudal group compared to TAP group. TAP block is more efficient and has less complications than caudal block in lower abdominal surgery.