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Corresponding Author

Samy Ahmed Ahmed Ali Kasim

Document Type

Original Article

Abstract

Background: There is growing evidence of the utilization of regional anesthesia in pediatric patients scheduled for lower abdominal surgery.

Aim: To assess the effectiveness of ultrasound-guided quadratus lumborum block (QLB) with ultrasound-guided caudal block in pediatric lower abdominal surgeries.

Patients and Methods: This randomized controlled study included 90 patients. Patients were randomly allocated to receive either QLB, caudal block, or general anesthesia. The primary endpoint is the cumulative opioid consumption within 24 hours following surgery. The secondary outcomes encompass pain score, time of initial analgesic request, vital signs, postoperative negative consequences, and parent satisfaction.

Results: Both QLB and caudal block groups exhibited significantly lower FLACC recordings than the control group at PACU 30 minutes, 1 hour, 2 hours, and 4 hours after surgery. FLACC score was significantly reduced in the QLB, contrasted with the caudal block and control groups at 6 and 12 hours after surgery (3.6 vs. 4.2 vs. 5.1, p= 0.041) and (2.8 vs. 3.5 vs. 5.5, p= 0.025), respectively. No significant disparities were observed across the study arms regarding vomiting, hypotension, bradycardia, and urine retention.

Conclusion: The current study revealed that QL block yielded superior and enduring pain relief in the first 24 hours following unilateral lower abdomen surgery in pediatric patients, contrasted with caudal block and control groups. Group QL exhibited a greater level of parental satisfaction. No serious adverse effects were reported in the study groups.

Keywords

FLACC (Face, Legs, Arms, Cry, Consolability) score; caudal block; Quadratus Lumborum block; Pain Management

Subject Area

Anesthesiology

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