Key result
US-guided TAP, caudal, and II/IH blocks reduce postoperative analgesia requirements versus IV ketorolac without complications.
Why the study?
Although US-guided TAP block, caudal block, and US-guided II/IH nerve block are safe and effective in children, their comparative effectiveness and occurrence of complications needed evaluation.
Do ultrasound-guided regional blocks (TAP, caudal, or II/IH) improve postoperative analgesia compared to intravenous ketorolac in children undergoing lower abdominal surgeries?
RCT (n=100)
randomized
Do ultrasound-guided regional blocks (TAP, caudal, or II/IH) improve postoperative analgesia compared to intravenous ketorolac in children undergoing lower abdominal surgeries?
Ultrasound-guided TAP, caudal, and II/IH blocks are safe and provide superior postoperative analgesia and parent satisfaction compared to intravenous ketorolac in children undergoing lower abdominal surgeries.
Supports US-guided blocks over IV ketorolac for pediatric lower abdominal surgery analgesia; extends RCT evidence for regional techniques in children.
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 ( n =25) received US-guided TAP block; group B ( n =25) received US-guided caudal block; group C ( n =25) received US-guided II/IH nerve; and group D ( n =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.
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El-Garhy et al. (2019) conducted an RCT in lower abdominal surgeries (n=100). US-guided TAP block, caudal block, or II/IH nerve block vs. Intravenous Ketorolac 0.5 mg/kg was evaluated on Postoperative analgesia requirements, objective pain score, postoperative complications, and parent satisfaction. US-guided TAP, caudal, and II/IH nerve blocks significantly reduced postoperative analgesia requirements compared to intravenous ketorolac, with no recorded postoperative complications.
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