الفهرس 
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Abstract
The surgical intervention (Trans-anal pull through operation) for children with congenital megacolon considers a difficult procedure due to narrowing of anal canal and weakness of internal sphincter that needs to adequate analgesia and muscle relaxant Balanced regional anesthesia considers not only an alternative to general anesthesia but as acomponant of the latter allowing significant reduction in the concentration of both inhalation and non –inhalation anesthetic – narcotic analgesics –muscle relaxant Caudal anesthesia in pediatric practice is the most popular among regional anesthesia In our study, we used peri –anal local infiltration and compared this with caudal anesthesia in its efficacy and postoperative pain relive, among pediatrics patient undergoing trans-anal pull through in congenital megacolon It revealed that peri-anal block was as effective as caudal in feasibility of surgery; surgeons were satisfied with sphincter tone But, it was less effective in postoperative pain relive compared to caudal anesthesia.