Ultrasound Guided Quadratus Lumborum Block Compared to Caudal Bupivacaine/ Neostigmine in Pediatric Lower Abdominal Surgeries, a Randomized Controlled Trial

Abstract

ostoperative pain management in pediatric patients undergoing lower abdominal surgeries is important for medical and ethical reasons. Postoperative pain management increases patient satisfaction and decreases the period of hospital stay. In pediatric anesthesia, good and long-lasting analgesia is essential to achieve happy children and satisfied parents. To guarantee this, many pediatric anesthetists include a variety of regional anesthetic techniques in their daily clinical practice. Regional anesthesia is a safe and effective method of analgesia, especially as a supplement to general anesthesia. QLB is an emerging technique for peripheral nerve blockade, which generates an analgesic effect by blocking spinal nerves from T6–T9 to L1-L3, considering its wide block range, it has been increasingly used for postoperative analgesia in patients undergoing middle and lower abdominal surgeries, and showed satisfactory. A single caudal injection of neostigmine 2 mcg/kg when added to bupivacaine 0.25% found to provide an extended duration of postoperative analgesia (≈20–22 h), and reduced the need for supplementary analgesics in children undergoing lower abdominal surgery. This duration is almost equal to the duration of analgesia provided by caudal bupivacaine co‐administered with neostigmine.