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Comparison of quadratus lumborum block and caudal block for postoperative analgesia in pediatric patients undergoing inguinal hernia repair and orchiopexy surgeries: a randomized controlled trial
  1. Gözen Öksüz1,
  2. Mahmut Arslan1,
  3. Aykut Urfalıoğlu1,
  4. Ahmet Gökhan Güler2,
  5. Şeyma Tekşen1,
  6. Bora Bilal1 and
  7. Hafize Öksüz1
  1. 1 Anesthesiology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
  2. 2 Pediatric Surgery, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
  1. Correspondence to Dr Gözen Öksüz, Anesthesiology, Kahramanmaras Sutcu Imam University, Kahramanmaras 46100, Turkey; gozencoskun{at}


Background and objectives Caudal epidural anesthesia is a widely used popular technique for postoperative analgesia but it has potential side effects and duration of analgesia is short. Quadratus lumborum block (QLB) was found to be an effective method for postoperative analgesia in lower abdominal surgeries. In this double-blind prospective randomized trial, we aimed to compare the postoperative analgesic efficacies of QLB and the caudal block in pediatric patients undergoing inguinal hernia repair and orchiopexy surgeries under general anesthesia.

Materials and methods After approval was obtained from the ethics committee, in this prospective randomized double-blind trial, 53 patients under general anesthesia undergoing inguinal hernia repair and orchiopexy surgeries randomly received caudal block or QLB. Demographic data, postoperative analgesic requirement, Face, Legs, Activity, Cry, and Consolability (FLACC) scores at 30 min, 1, 2, 4, 6, 12 and 24 hours, parent satisfaction scores and complications were recorded.

Results The study included 52 patients, after excluding one patient because of a failed caudal block. There were no significant differences between the groups based on demographic data (p>0.05). The number of patients who required analgesics in the first 24 hours was significantly lower in QLB group (p=0.001). Postoperative 4, 6, 12 hours FLACC scores were significantly lower in the QLB group (p<0.001, p=0.001 and p<0.001, respectively). Parent satisfaction scores were higher in the QLB group (p=0.014).

Conclusion According to the results of this study, QLB can provide much more effective analgesia than caudal block without adjuvants in multimodal analgesia management of children undergoing inguinal hernia repair and orchiopexy surgeries.

Trial registration number NCT03294291.

  • Pediatric pain
  • postoperative pain
  • truncal blocks

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  • Contributors Study conception and design: GÖ, MA, AGG, BB, HÖ, AU, ŞT. Analysis and interpretation of data: GÖ, ŞT, MA. Drafting of the manuscript: GÖ, AGG, BB, AU, HÖ. Critical revision of the article: GÖ, MA, HÖ. Final approval of the version to be published: GÖ, AGG, MA, ŞT, BB, HÖ, AU.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.