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Caudal Block versus Wound Infiltration for Inguinal Procedures in Young Children: A Randomized Clinical Study
Sabine Zundel1, Franziska Conz2, Jörg Fuchs2
1Department of Pediatric Surgery, Luzerner Kantonsspital, Spitalstrasse, Luzern, Switzerland.
Insights
Local wound infiltration (LI) and caudal block (CB) provide effective pain relief for pediatric inguinal procedures. LI offers a shorter setup time and fewer complications, making it a recommended option for outpatient surgery.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Pain Management
Background:
- Inguinal procedures are common in pediatric outpatients.
- Effective pain management and efficient operating room setup are crucial.
Purpose of the Study:
- To compare postoperative pain scores and setup times between caudal block (CB) and local wound infiltration (LI) for pediatric inguinal procedures.
Main Methods:
- Pediatric outpatients undergoing inguinal procedures were randomized.
- Patients received either preincision CB or end-of-procedure LI.
- Postoperative pain and setup time were analyzed.
Main Results:
- No significant difference in postoperative pain scores was observed between the CB and LI groups.
- Setup time was significantly longer for the CB group (median 22.5 minutes) compared to the LI group (median 17 minutes).
Conclusions:
- Both CB and LI provide adequate pain control for pediatric inguinal surgery.
- LI is recommended due to its shorter setup time and lower complication risk.
- Further research in larger cohorts is needed to confirm these findings and their impact on patient care and efficiency.
Introduction:
Inguinal procedures in children are frequent and typically performed in an outpatient setting. We aimed to analyze whether there is a difference in postoperative pain scores and setup time (start of anesthesia management to incision time) when comparing caudal block (CB) with local wound infiltration.
Materials And Methods:
We enrolled pediatric outpatients scheduled for inguinal procedures. Patients were randomized to receive either preincision CBs or end-of-procedure local wound infiltration. Postoperative pain scores until 24 hours postoperatively and setup time were analyzed.
Results:
Fifty-two patients were included in the study. Thirty patients received a CB, and 22 patients received local infiltration (LI). There was no significant difference in postoperative pain scores. Setup time was significantly higher in the CB group: median 22.5 minutes IQR (16-46 minutes) compared with 17 minutes in the LI group IQR (10-35 minutes), p-value of 0.0026.
Conclusion:
Both CB and LI result in good postoperative pain control after inguinal procedures in pediatric outpatients. Since LI is less time consuming and has lower risks for complications, we recommend this technique for inguinal procedures in pediatric outpatients. Our findings will need to be confirmed in larger cohorts, but we believe the evidence generated with this study has the potential to positively influence patient care, operating room efficiency, and costs.
