Background and Aims Inguinal hernia repair (IHR) is a cause of severe pain in pediatric patients[1,2]. We aimed to compare ultrasound (US) guidedcaudal epidural block (CEB) versus transversus abdominis plane block (TAPB) in terms of postoperative analgesia and chronic pain development in pediatric bilateral open IHR.
Methods After Istanbul Faculty of Medicine Clinical Research Ethics Committee approval (2017/1123) seventy patients aged between 1–7 years undergoing bilateral open IHR were included in this randomized clinical trial. Patients received CEB (Group C) or bilateral TAPB (Group T). FLACC scores were examined for acute pain during the postoperative 24 hours. Postoperative additional analgesic requirement, procedural complications, postoperative nausea-vomiting incidence, family/surgeon satisfaction, length of hospital stay were recorded. “Revised Bieri faces pain scale” was used to evaluate chronic pain in postoperative 2nd month.
Results The study was completed with 60 patients. FLACC scores at 6th and 24th hour were lower in Group T (p<0.05) (Table 1). In line with this, additional analgesic requirement was more in Group C for postoperative 24 hours (p<0.05). Procedural complications, nausea-vomiting incidence and chronic pain occurrence did not differ between the groups (p>0.05). Group T patients were discharged earlier also (p<0.05) (Table 2). A total number of 21 patients (8 in Group C, 13 in Group T) were questioned for chronic pain and all of them exhibited “zero” points.
Conclusions CEB and TAPB have similar postoperative analgesic efficacy in the first 6 hours for pediatric inguinal hernia repair whereas TAPB provides superior analgesia for the latter period. Both is efficient for preventing chronic pain.
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