Analgesic Efficacy of Ultrasound Guided Transversus Abdominis Plane Block Versus Caudal Block in Inguinal Hernia Repair Surgery in Pediatrics
Mekawy, M., Refky, M., Farid, D., Amer, A. (2020). Analgesic Efficacy of Ultrasound Guided Transversus Abdominis Plane Block Versus Caudal Block in Inguinal Hernia Repair Surgery in Pediatrics. EKB Journal Management System, 26(4), 620-630. doi: 10.21608/zumj.2019.13760.1265
Mohammed Mekawy; Mohammed Anwer Refky; Doaa Mohammed Farid; Ayat Ahmed Amer. "Analgesic Efficacy of Ultrasound Guided Transversus Abdominis Plane Block Versus Caudal Block in Inguinal Hernia Repair Surgery in Pediatrics". EKB Journal Management System, 26, 4, 2020, 620-630. doi: 10.21608/zumj.2019.13760.1265
Mekawy, M., Refky, M., Farid, D., Amer, A. (2020). 'Analgesic Efficacy of Ultrasound Guided Transversus Abdominis Plane Block Versus Caudal Block in Inguinal Hernia Repair Surgery in Pediatrics', EKB Journal Management System, 26(4), pp. 620-630. doi: 10.21608/zumj.2019.13760.1265
Mekawy, M., Refky, M., Farid, D., Amer, A. Analgesic Efficacy of Ultrasound Guided Transversus Abdominis Plane Block Versus Caudal Block in Inguinal Hernia Repair Surgery in Pediatrics. EKB Journal Management System, 2020; 26(4): 620-630. doi: 10.21608/zumj.2019.13760.1265

Analgesic Efficacy of Ultrasound Guided Transversus Abdominis Plane Block Versus Caudal Block in Inguinal Hernia Repair Surgery in Pediatrics

Zagazig University Medical Journal
Article 12, Volume 26, Issue 4, July 2020, Page 620-630  XML PDF (676.71 K)
Document Type: Original Article
DOI: 10.21608/zumj.2019.13760.1265
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Authors
Mohammed Mekawy email 1; Mohammed Anwer Refky2; Doaa Mohammed Farid3; Ayat Ahmed Amer3
1anesthesia and surgical Intensive care department, faculty of medicine, zagazig university, Zagazig, Egypt
2anesthesia and surgical intensive care department, faculty of medicine, Zagazig university, Zagazig, Egypt.
3Anesthesia and surgical intensive care department, faculty of medicine, Zagazig university, Zagazig, Egypt.
Abstract
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.
Keywords
caudal; TAP; Ultrasound; Pediatric; Surgery
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