Efficacy of Caudal Epidural Block with 0.2% Ropivacaine in Paediatric Patients Undergoing Laparoscopic Unilateral Hernia Repair: A Prospective Randomized Study

Background and Objectives: The assessment and quantification of postoperative pain is more difficult in children than adults. Regional anesthesia and analgesia has shown to provide excellent analgesia and also provide benefits, which extend beyond the perioperative period. Caudal epidural block is a gold standard technique in paediatric lower abdominal surgeries. The aim of this study is to evaluate perioperative effect of caudal epidural block in children undergoing laparoscopic hernia repair surgeries regarding hemodynamic changes in intra-operative period, postoperative pain score, rescue analgesia requirement and any side effects. Methods: Sixty children aged 2–12 years with ASA grade I or II scheduled for laparoscopic unilateral hernia repair were randomly allocated into two groups: group A (General anaesthesia with caudal block) and group B (General anaesthesia without caudal block). Postoperative pain scores, rescue analgesic requirement, intraoperative hemodynamic changes, any complication related to caudal block were recorded. Results: All children were comparable regarding demographic profile. There was no statistically significant difference in hemodynamic changes between both the groups. The mean postoperative pain score was significantly lower in group A (2.98 ± 1.08) as compared to group B (3.63 ± 1.49) (p = 0.002). Eleven (36%) subjects in group A and 25 (83%) subjects in group B needed rescue analgesic in postoperative period. The incidence of adverse effects was higher (30%) in group A than group B (13%). Conclusion: We concluded that caudal bock with 0.2% ropivacaine in paediatric patients provides better analgesia, without significant intraoperative hemodynamic changes.