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A Prospective Randomized Study to Compare Ultrasound Guided Transversus Abdominis Plane Block and Caudal Epidural

Monika Gandhi1, Nidhi Sharma1, Damodar Patra1

  • 1Department of Anaesthesia, MGM Medical College & MY Hospital, Indore, Madhya Pradesh, India.

Journal of Pharmacy & Bioallied Sciences
|March 19, 2026
PubMed

Insights

Ultrasound-guided transversus abdominis plane (TAP) block provided superior postoperative pain relief compared to caudal epidural block in pediatric abdominal surgery patients. TAP block resulted in longer-lasting analgesia and reduced overall pain medication needs.

Area of Science:

  • Pediatric Anesthesiology
  • Regional Anesthesia
  • Pain Management

Background:

  • Effective perioperative pain management is crucial for pediatric recovery and discharge.
  • Pediatric abdominal surgeries often require robust postoperative analgesia.
  • Regional anesthesia techniques are explored to optimize pain control in children.

Purpose of the Study:

  • To compare the efficacy of ultrasound-guided transversus abdominis plane (TAP) block versus caudal epidural block for postoperative analgesia.
  • To evaluate pain scores, analgesic requirements, and hemodynamic stability in pediatric patients undergoing abdominal surgery.

Main Methods:

  • A randomized study involving 80 children (aged 1-6 years) undergoing abdominal surgery.
  • Group T received ultrasound-guided TAP block with 0.25% bupivacaine.
  • Group C received caudal epidural block with 0.25% bupivacaine; pain assessed using FLACC score.

Main Results:

  • Mean time to first rescue analgesia was significantly longer in the TAP block group (10.8 hr) compared to the caudal block group (7.2 hr).
  • Total 24-hour analgesic requirement was substantially lower in the TAP block group (147.33 mg) versus the caudal block group (218.67 mg).
  • Hemodynamic parameters were monitored intraoperatively.

Conclusions:

  • Ultrasound-guided TAP block offers superior and prolonged postoperative pain relief in pediatric abdominal surgery.
  • TAP block leads to reduced analgesic consumption and supports stable vital signs post-surgery.
  • TAP block is an effective regional anesthesia technique for pediatric postoperative pain management.
Abstract

Keywords:
Caudal blockpaediatric anaesthesiapostoperative analgesiatransversus abdominis plane block

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