Comparison of ultrasound-guided transversus abdominis plane block, quadratus lumborum block, and caudal epidural block for perioperative analgesia in pediatric lower abdominal surgery

Abstract

Background/aim: Despite different regional anesthesia techniques used to provide intraoperative and postoperative analgesia inpediatric patients, the analgesic effectiveness of peripheral nerve blockades with minimal side effect profiles have not yet been fullydetermined.We aimed to compare the efficacy of ultrasound-guided transversus abdominis plane (TAP) block, quadratus lumborum (QL) block,and caudal epidural block on perioperative analgesia in pediatric patients aged between 6 months and 14 years who underwent electiveunilateral lower abdominal wall surgery.Materials and methods: Ninety-four patients classified under the American Society of Anesthesiologists physical status classificationsystem as ASA I or ASA II were randomly divided into 3 equal groups to perform TAP, QL or Caudal epidural block using 0.25% ofbupivacaine solution (0.5 ml kg−1).Results: Postoperative analgesic consumption was highest in the TAP block group (P < 0.05). In the QL block group, Pediatric ObjectivePain Scale (POAS) scores were statistically significantly lower after 2 and 4 h (P < 0.05). The length of hospital stay was significantlylonger in the caudal block group than the QL block group (P < 0.05).Conclusion: We suggest that analgesia with ultrasound-guided QL block should be considered as an option for perioperative analgesiain pediatric patients undergoing lower abdominal surgery if the expertise and equipment are available.