# Comparıson of analgesıc effectıveness of ultrasound-guıded caudal epıdural block and transversus abdomınıs plane block ın chıldren undergoıng unılateral ınguınal hernıa repaır: randomized controlled study

## TL;DR

This study compares two pain relief techniques in children after hernia surgery and finds that the TAP block provides longer-lasting pain relief with fewer additional pain medications.

## Contribution

The study provides a direct comparison of analgesic effectiveness between ultrasound-guided caudal and TAP blocks in pediatric inguinal hernia repair.

## Key findings

- Both TAP and caudal blocks provided adequate analgesia for the first 4 hours post-surgery.
- TAP block showed a longer-lasting effect with lower need for rescue analgesics after 6 hours.
- No significant difference in total analgesic use at 12 hours between the two groups.

## Abstract

The introduction of ultrasound-guided nerve blocks has led to significant advancements in pediatric postoperative analgesia. In this context, the caudal block (C), a well-established and effective analgesic technique used for many years, has been increasingly complemented by the transversus abdominis plane (TAP) block, which is thought to have fewer side effects and potentially greater efficacy. The aim of our study was to compare these two methods in terms of postoperative analgesic effectiveness.

This study was conducted as a prospective, randomized, controlled trial. A total of 56 children, aged 1 to 10 years, classified as ASA I and II, undergoing elective inguinal hernia repair, were included. The patients were randomly assigned into two groups. Group T (n = 28) received a TAP block with 0.5 mL/kg of 0.25% bupivacaine under ultrasound guidance, while Group C (n = 28) received a caudal block with the same concentration and volüme of bupivacaine.

The primary outcome of the study was the duration of postoperative analgesia, while secondary outcomes included the need for rescue analgesics, complications, and the effects on hemodynamic parameters.

During the postoperative period, adequate analgesia was achieved in both groups for up to the first 4 h. However, after the 6th hour, there was a significant increase in pain scores in the caudal block group. The need for rescue analgesics was lower in the TAP group, although there was no difference in the total amount of analgesics used at 12 h.

Both TAP block and caudal block are effective in providing postoperative analgesia for children undergoing inguinal hernia repair. The TAP block may be preferred due to its longer-lasting postoperative effect and lower need for rescue analgesics.