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Background and Aims Loco-regional anaesthesia (LRA) has enjoyed incredible growth, and plays a key role in the multimodal approach to post-operative pain management in children. The latest studies show a significant regression of central blocks, and mainly caudal blocks, in favor of peripheral nerve blocks. In the past, caudal nerve block (CB) was commonly indicated in pediatric surgery, despite its particularities, risk of complications and relatively short duration of analgesia. Today, lumbar square nerve blocks (LSB) have proved to be an effective method of postoperative analgesia. The aim of our study is to compare CB with LSB in the surgical treatment of inguinal hernia and testicular ectopia in children.

Methods Materials and methods: This was a prospective, randomized, double-blind study comparing the postoperative analgesic efficacy’ of caudal block versus BCL in pediatric patients who had undergone surgery for inguinal hernia and testicular ectopia under general anesthesia. Sixty children were included, and demographic characteristics, use of intravenous analgesics, complications, FLACC score at H1,2,6 and 12 hours postoperatively, and parental satisfaction by Likert score were collected.

Results Results: 60 patients were included, thirty in each group. there were no significant differences between groups in demographic data (p>0.05). The need for intravenous analgesics for the first 12 hours postoperatively was significantly lower in the LSB group (p = 0.002). FLACC scores over 12 hours were significantly lower in the LSB group (H2and H12 respectively p=10-3, and p=0.02). Parental satisfaction scores were higher in the LSB group (p=0.0112).

Conclusions Conclusion LSB may be a promising alternative in pediatric anesthesia.