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Abstract
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Background and Aims Renal surgeries in pediatrics often result in significant post-operative pain, necessitating effective analgesia for early recovery and complication minimization. While caudal epidural block is commonly used, its short duration often requires adjuncts like morphine or clonidine, which can cause adverse effects. Recently, the Multiple Injection Costotransverse Block (MICB) has been introduced, showing promising perioperative analgesia. This study aims to compare the analgesic efficacy of MICB to caudal block in pediatric renal surgeries by evaluating the total fentanyl requirement within 24 hours post-surgery
Methods In this study, 56 children undergoing renal surgery were divided into two groups with 28 children in each group. Group CB/caudal block received 0.2% Ropivacaine 1.25ml/kg and Group MICB/multiple injection costo transverse block received 0.2%Ropivacaine 2mg/kg under usg guidance
Results The MICB group showed significantly lower mean fentanyl consumption (0.57 ± 0.17 mcg/kg) compared to the caudal block (0.84 ± 0.31 mcg/kg) (p=0.03). Fewer patients in MICB group(32.14%) needed rescue analgesia within 24 hours compared to caudal block (53.57%). MICB also prolonged time to rescue analgesia (4 hrs vs. 2 hrs) and had higher parental satisfaction (p=0.01). No complications occurred
Anatomy, positioning, usg image
Primary outcome
Conclusions In children undergoing renal surgeries, MICB offers better, safer, and prolonged post-operative analgesia with higher parental satisfaction than caudal epidural block. It should be considered as an alternative, requiring ultrasound-guided expertise.