Comparative study between different ultrasound-guided techniques for postoperative analgesia in children undergoing lower abdominal surgeries

Background and aim
Ultrasound (US)-guided transversus abdominis plane (TAP) block, caudal block, and US-guided ilioinguinal/iliohypogastric (II/IH) nerve block are safe and effective methods in children. The aim of the study was to compare the effectiveness and occurrence of complications.
Patients and methods
A total of 100 patients undergoing lower abdominal operations (infraumbilical incision) between 5 and 10 years were included in the study. The patients scheduled for elective operation were randomized into four groups: group A (=25) received US-guided TAP block; group B (=25) received US-guided caudal block; group C (=25) received US-guided II/IH nerve; and group D (=25) received Ketorolac 0.5 mg/kg intravenously to be considered as the control group. The Objective pain score, postoperative complication, satisfaction of the parents, and postoperative analgesic requirements were recorded.
Results
Postoperative analgesia requirements were significantly higher in group D compared with group A, B, and C; meanwhile, it was significantly highest in group D compared with both groups A and group B. There was significant difference between group A and group D in pain score assessment, but no significant difference between group A and group B. Patient and parent satisfaction was markedly observed in groups A and B more than in group D (the control group) and more satisfaction in group A than group B.
Conclusion
TAP block, caudal block, and US-guided II/IH nerve blockade under US guidance proved to be safe with no recorded postoperative complications. Patient and parent satisfaction was markedly observed in case of TAP block.