Background: Regional anesthesia techniques as a caudal epidural block (CEB) are commonly used to help with pain control during pediatric surgeries, decrease parenteral analgesics requirement, and improve the quality of postoperative pain control and general satisfaction of patient parents. Transversus abdominis plane (TAP) block is an evolving modality of regional anesthetic techniques for the abdominal wall. Objective: The aim of the current study was to compare the analgesic effect of CEB versus TAP block in pediatrics undergoing infraumblical surgeries. Patients and methods: A total of 120 kids between the ages of 4 and 7 years old who needed infraumbilical procedures were divided into two groups of 60 patients. Group (1) received caudal epidural block using Plain bupivacaine 0.25 % 1 ml/kg, and Group (2) received ultrasound-guided TAP block using plain bupivacaine 0.25% 1 ml/kg. Follow up postoperative pain using Faces Pain Scale-Revised, vital signs, first rescue analgesia, the total dose of paracetamol needed, and complications. Results: At 8 and 18 hours postoperatively, Group (1) had substantially lower pain scores on the Faces pain scale-revised, reduced heart rate and mean arterial pressure compared to Group (2). Group (1) had a considerably later time to first rescue analgesia with less paracetamol use than Group (2). There was no discernible difference in postoperative complications between groups (1) and (2). Conclusion: At 6-24 hours after block placement, caudal block provides superior analgesia compared to TAP block in children undergoing lower abdominal surgeries. Caudal block is an effective, feasible, and safe option for postoperative analgesia, especially when compared to TAP block.

Background: Caudal block is one of the most common regional anesthetic techniques used in children. It is considered safe and simple procedure but its main disadvantage is its relatively short duration of action even with use of long acting agents such as bupivacaine. Fentanyl is most common additive to local anesthetics to caudal block, but it has undesirable side effects. Dexmedetomidine is α2 adrenergic receptor agonist which prolongs the duration of analgesia when added to caudal bupivacaine. Objective: This work aimed to compare the postoperative analgesic and any side effects of addition of either dexmedetomidine or fentanyl to bupivacaine in pediatric patients undergoing lower abdominal and lower limb surgeries. Patients and methods: This interventional randomized-controlled study was carried out in Department of Anesthesia and Intensive Care, Sohag University Hospital. Sixty patients aged from 2 to 6 years who were going to do a lower abdominal surgery were included in the study. Results: As regards sedation score, dexmetedomidine showed more sedation than that of fentanyl where there was a significant difference between both groups at ½ hour and 1 hour (P value 0.008 and 0.016 respectively) and number of children sedated in group D (23) was more than that of group F (8) at 1 hour. Conclusion:Adding dexmetedomidine to bupivacaine in caudal block is longer in duration of postoperative analgesia and showed more sedation time than that of fentanyl with more stability in haemodynamics.