A comparative randomized study of USG guided transversus abdominis plane block versus caudal block for post operative analgesia in paediatric unilateral open inguinal hernia repair

Abstract

Background: Inguinal hernia surgery is associated with moderate to severe post-operative pain especially in paediatric age groups as pain threshold is lesser in children so in this study our aim was to compare usg guided transversus abdominis plane block and caudal block for post-operative analgesia for unilateral inguinal hernia repair surgeries. Materials and Methods: 60 pediatric patients of American society of anaesthesiologist (ASA) I /II aged 1-8 years of either gender, scheduled for elective open unilateral inguinal hernia repair under general anesthesia were divided into two groups. Patients of group 1 were given caudal block group using 0.25% bupivacaine 1ml/kg and group 2 were given ultrasound guided TAP block using 0.25% bupivacaine 0.5ml/kg. The postop analgesic efficacy, hemodynamic stability, degree of motor weakness and Adverse effects if any was noted. Results: There was no significant difference in median CHEOPS score until 6 hours in postoperative period. No Significant difference was observed in hemodynamic parameters in intraoperative and postoperative period. All patients in both the groups were comfortable with a CHEOPS score between 5-6 in the post-operative period with no opiate requirements. No significant haemodynamics changes and adverse effects were observed. Conclusion: We found that children in both the study groups i.e caudal block and USG guided TAP block were having stable intraoperative and post-operative hemodynamic conditions. Post-operative analgesia measured using CHEOPS score was maintained between 5-6 and patients in both groups were comfortable throughout the study period. There was no need of any rescue analgesia during post-operative period for the study period of 6 hours.