A comparison between caudal block versus splash block for postoperative analgesia following inguinal herniorrhaphy in children

Abstract

BackgroundWe wanted to determine the postoperative analgesic efficacy of preincisional caudal epidural block versus instillation (splash block) following inguinal herniorrhaphy in children.MethodsThirty children (age range: 1-7 years) who were scheduled to undergo inguinal herniorrhaphy were divided into 2 groups: the caudal block group and the splash block group with 15 children in each group. Tracheal intubation was performed. Fifteen children received caudal block with 1.0 ml/kg of 0.25% ropivacaine (Group 1). Caudal block was performed using the loss of resistance method via the sacral hiatus. Fifteen children in Group 2 received local instillation (splash block) in the surgical site with up to 0.4 ml/kg of 0.25% ropivacaine. The patients were observed for 90 minutes in the postanesthesia care unit and then they were transferred to the ward. The pain scores were taken 4 times. We assessed pain using the Faces pain scores.ResultsThere were no significant differences between the groups regarding the pain scores at 10, 30 and 60 minutes upon entering the postanesthesia care unit. The pain scores of Group 1 were slightly lower at the last evaluation point when compared to that of Group 2. One patient in Group 1 required supplemental postoperative intravenous (IV) tramadol, while all the other patients in both groups did not require supplemental IV tramadol. The intraoperative requirement for sevoflurane was decreased in Group 1 as compared to that of Group 2. There were no major complications related to either type of block.ConclusionsWe conclude that a splash block can have a similar analgesic effect as that of a caudal block for the postoperative herniorrhaphy pain of children.

A Systematic Review and Meta-Analysis of Caudal Block as Compared to Noncaudal Regional Techniques for Inguinal Surgeries in Children

“…Out of 3240 items, 1958 reports were obtained after removing duplicates. Finally, 27 full-text articles were considered for inclusion out of which 17 were included ( Table 3 ) [ 8 – 24 ], and three were excluded [ 25 – 27 ]. Of the remaining seven studies [ 28 – 34 ], two were journal reports and five were conference proceedings.…”

A Comparative Study of Caudal Block and Ultrasound-Guided Transversus Abdominis Plane Block With Levobupivacaine and Dexamethasone as Additive in Extraperitoneal Lower Abdominal Surgeries in Pediatrics

“…Cheon et al [20] who compared caudal block with local infiltration in children undergoing inguinal herniorrhaphy noticed that children in the caudal group did not need rescue analgesic; however, in that study, post-operative pain was assessed for 2 h only, whereas in our study, assessment was done till 24 h postoperatively.…”

Comparison of two bupivacaine delivery methods to control postoperative pain after enucleation in dogs

“…In human and veterinary medicine, numerous studies show the level of analgesia obtained using a splash block is comparable to that of infiltrative or local nerve blocks . A splash block refers to the direct application of a local anesthetic to the site of interest.…”