TransversusAbdominis Plane Block versus Caudal Epidural for Lower Abdominal Surgery in Pediatrics

Abstract

Regional anesthesia is a cornerstone of modern pediatric anesthesia, with a large number of pediatric anesthetists combining general and regional anesthesia to provide superior and long-lasting analgesia without risk of respiratory depression. Although caudal epidural blockade remains the most commonly employed regional block in the pediatric-aged patient, there is a trend toward the use of peripheral nerve blockade when applicable given the lower incidence of adverse effects when compared with neuraxial techniques. Furthermore, there may be specific anatomic variations or abnormalities, which preclude the use of caudal epidural blockade including bleeding disorders and coagulopathy, spinal dysraphism, bony anatomical abnormalities (VACTERL association) and those with altered intracranial compliance. The transversusabdominis plane (TAP) block is increasingly being used to provide analgesia after surgery involving the abdominal wall. Rafi introduced this block technique in 2001 as a landmark technique. In the present study 60 patients from both sexes, aged 10mon- 6years, weighing between 7.5-25 kgs scheduled for elective lower abdominal surgery were allocated in two groups: 30 patients received caudal block and 30 patients received bilateral ultra sound guided TAP block.