Comparison of Transversus Abdominis Plane Block and Caudal Block for Postoperative Analgesia in Children Undergoing Lower Abdominal Surgery

Introduction Providing postoperative analgesia have become imperative in pediatric anaesthesia practice. Caudal block is being used with greatest frequency for postoperative analgesia in pediatric patients. Recently there is a trend toward the use of peripheral nerve blockade. TAP block is a new and rapidly evolving peripheral nerve block technique. To date, there is paucity of literature regarding comparison of USG TAP block and caudal block. This study aimed to evaluate TAP block and caudal block for duration and quality of analgesia postoperatively in children. Materials and methods 60 children aged 1- 12 years were randomly allotted into 2 groups to receive either USG TAP block with 0.3ml/kg of 0.2 % ropivacaine or caudal block with 1ml/kg of 0.2 % ropivacaine after induction of anesthesia. Parameters observed included duration of analgesia by modified VAS scale, total analgesic requirement in 24 hours, quality of analgesia and adverse effects. Results Mean VAS scores were lower in both the groups for first 3-4 hours postoperatively. Subsequently, number of patients with mean VAS score greater than3 rose more rapidly in group Caudal as compared to group TAP. Time to rescue analgesia in group TAP was 7.41 0.78 hours whereas in group Caudal was 5.07 0.69 hours and this difference was statistically significant. The difference was not statistically significant for total analgesic requirement between the two groups. Quality of analgesia was good in both the groups. No adverse effects were reported in both the groups. Conclusion Duration of analgesia was significantly longer in children who received TAP block as compared to caudal block and it is a good alternative for providing postoperative analgesia.