Objective: To compare the effectiveness of Bupivacaine local wound infiltration with Bupivacaine caudal block on postoperative pain in children undergoing open inguinal hernia repair. Study Design: Quasi-experimental study. Place and Duration: Department of Paediatric Surgery, Pak Emirates Military Hospital Rawalpindi, from Jan to Sep 2019. Methodology: 60 patients (30 each in two groups) fulfilling the inclusion criteria who underwent open inguinal herniotomy were included in this study. Patients in group-A received caudal block with 0.25% Bupivacaine 1 ml/kg body weight, while Group-B received local wound infiltration of 0.5% Bupivacaine 2 mg/kg body weight after the completion of surgery. The post-operative pain score was calculated using Hannallah's objective pain scale at 30 minutes, one, two, four, six and eight hours following the procedure. A total pain score of 3 requiring the rescue analgesia in the form of oral Paracetamol (10 mg/kg body weight) was considered the endpoint. Results: Mean post-operative pain score was 8.20 ± 1.54 in group-A compared to 7.20 ± 1.88 in Group-B with the p-value of 0.02, which showed a statistically significant difference between the two groups. Conclusion: We concluded that local infiltration with Bupivacaine after open herniotomy in children is safe, highly effective and easy to perform the procedure, which results in excellent post-operative analgesia compared to caudal Bupivacaine block.

Objective: To compare operative time, hospital stay and post-operative complications between laparoscopic and open pyloromyotomy. Study Design: Randomized Prospective study. Setting: Department of Paediatric Surgery, Pak Emirates Military Hospital, Rawalpindi. Period: 7th May 2022 to 7th November 2022. Material & Methods: This study included 20 patients each in the two groups. Group A underwent laparoscopic whereas group B underwent open pyloromyotomy. Both groups were compared regarding operative time (OT), hospital stay (HS) and post-operative complications. Results: OT ranged from 20 to 70 min with a mean of 15.4 min in group A. In group B, the mean OT was 25.6 min (range, 25–60 min). HS ranged from 14 to 58 hours with a mean of 16.8 hours in group A. In group B, it ranged from 19 to 30 hours, and the mean was 24.2 hours. One case in group A was converted to open approach (conversion rate 5%) because of mucosal perforation while one case of incomplete pyloromyotomy was found. Conclusion: Laparoscopic technique has shorter operative time and hospital stay than open surgery. Complication like mucosal perforation were seen in laparoscopy group, however, it was not found statistically significant.