الفهرس 
Local AnestheticsOnly 14 pages are availabe for public view
 |  | from | 88 |  |  |
| | | from | 88 | | |
Abstract
Inguinal hernia repair is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provide safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery.
Regional anesthetic techniques are commonly used to facilitate pain control in pediatric surgical procedures. The most commonly used techniques in pediatrics are caudal block and TAP block.
This study was to compare the effectiveness and safety of US guided TAP block versus caudal block as a part of multimodal analgesia in pediatric patients undergoing inguinal hernia repair.
The study was conducted on 90 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. patients were divided randomly into two groups, each group consisted of 45 patients.
After preoperative assessment and obtaining baseline vital data, all patients received general anesthesia.
group A:
Patients in this group received US guided TAP block on the same side of surgery. linear ultrasound probe was placed in the mid-axillary plane midway between the lower costal margin and the highest point of iliac crest. A 23-G 50-mm needle with an injection line was inserted in plane with the probe. Once the tip of the needle was placed in the space between the internal oblique abdominal muscle and transversusabdominis muscle, and after negative aspiration, 0.5 ml/kg 0.25% bupivacaine was injected.
group B:
Patients in this group received caudal block, patients were placed in left lateral position, caudal block was administered under sterile conditions with a 50 mm 23–G needle using a standard loss of resistance technique. After negative aspiration, 1ml/kg of 0.25% bupivacaine was injected.
The two groups were adequately monitored and assessed intra- and post-operatively and they were compared regarding demographic data, intra and postoperative hemodynamics, postoperative pain control using CHIPPS score in the 1st 2h postoperatively, complications of both anesthetic techniques and parents satisfaction.
The results of the study revealed that US guided TAP block provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and better parents satisfaction as compared with caudal block in pediatric patients undergoing inguinal hernia. Both analgesic techniques are safe.