European Journal of Molecular & Clinical Medicine

Abstract

Introduction: Inguinal hernia repair, the commonly performed surgery in pediatric patient, is associated with significant postoperative pain. Transversus abdominis plane (TAP) block is the newly used regional technique for providing analgesia after abdominal surgeries. Use of ultrasound in regional anaesthesia has improved the safety and reliability of the TAP block and caudal block. There is limited literature comparing the effect of USG guided Transversus abdominis plane block and USG guided caudal block for post-operative analgesia.The aim of our study is to compare post-operative analgesia in USG guided Transversus abdominis plane block versus USG guided caudal block in unilateral open herniotomy in paediatric age group.
Methods: After approval of Institute ethical committee and parental consent, total of 60 patients of ASA I & ASA II physical status, aged between 2-8 years scheduled for elective open inguinal hernia repair surgery were randomly divided into 2 groups: Group T and Group C. After induction of general anaesthesia, Group C received USG guided Caudal block with 1ml/kg of 0.2% ropivacaine & Group T received USG guided TAP block with 0.5ml/kg of 0.2% ropivacaine. Inj. Paracetamol IV 15mg/kg was given in case of failed block.
The primary outcome variable duration of postoperative analgesia using CHEOPS score and the secondary outcomes like HR, BP, SPO2, were measured at 0,1,2,4,6,8,12,16,24 hours respectively and adverse effects, if any were noted.
Results: There was no significant difference in median CHEOPS score till 6 hours of postoperative period among both the groups and thereafter significantly lower CHEOPS score was found in Group T till 24 hours postoperative period, when compared to Group C. Mean duration of analgesia was 563.45±61.31 minutes in Group T, whereas in Group C, it was 362.59±32.54 minutes.
Conclusion: Thus, we conclude that USG-guided Transversus abdominis plane block provided longer duration of analgesia and reduced rescue analgesic dose without any significant adverse effects when compared with USG guided caudal block after inguinal herniotomy.