Ultra-Sound Guided Caudal Epidural Blockade Analgesia in Comparison to Paravertebral Blockade for Lower Abdominal Operative Interventions among Children Volume 2 - Issue 4

Sabri A Soltan¹*, Hesham S Abdelraouf¹ and Mahmoud M Alsagheir²

• ¹Department of Anesthesia, Faculty of Medicine, Al Azhar University, Egypt
• ²Department of Anaesthesia, Faculty of Medicine, Al Azhar University, Assiut, Egypt

Received: December 27, 2019;  Published: January 07, 2020

Corresponding author: Sabri A Soltan, MD, Department of Anesthesia, Faculty of Medicine, Al Azhar University, Egypt

DOI: 10.32474/GJAPM.2020.02.000141

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Abstract

Background: Adequate analgesia post-operative is crucial to permit early mobilization and effective cough in order to decrease the respiratory system issues and complications. The usage of peripheral nerve blockage in conjunction with sonographic technology and neural stimulators have resulted in better fascial planes identification.

Aim: To compare the analgesic effectiveness of sonographic -guided caudal epidural blockage versus sonographic -guided single-shot thoraco-lumber paravertebral blockage in pediatric cases undergoing lower abdominal surgeries such as herniotomy.

Methodology: This is a prospective randomized interventional clinical research trial performed in Department of Anesthesiology, Samir Abbas Hospital ‘Saudi Arabia to compare single-shot caudal Blockage to single-shot paravertebral blockage conducted on sixty pediatric cases. Categorized randomly into two equal numbered research groups: research Group C (caudal Blockade) and research Group P (paravertebral blockade).

Results: Comparative statistical analysis of research group C (Caudal blockage research group) and research group P (paravertebral blockage research group) as regards Postoperative FLACC ( Face, Legs, Activity, Cry, Consolability) scoring level in which there was no statistical significant difference between both research groups at 0, 0.5, 1, 2, scoring levels p values =0.605, 0.192, 0.076, 0.130 consecutively) whereas there was statistical significant higher scoring levels among research group C study subjects in comparison to research group p study subjects at 3^rd, 6^th, 12^th and 24^th hours. (p values=0.031, 0.002, 0.000, 0.000 consecutively).

Conclusion: analgesia after Sonographic-guided paravertebral blockade administering (bupivacaine 0.25 % 1mg /kg) is superior in analgesic effects in comparison to sonographic guided mode of caudal epidural blockade.

Abstract| Introduction| Aim of the Work| Methodology| Caudal Blockage| Caudal Space Anesthetic Anatomy| Anatomic Landmarks| Paravertebral Blockage| Lumbar Paravertebral Space Anesthetic Anatomy| Anesthetic Blockage Mechanism of Paravertebral Space| Statistical Analysis| Results| Discussion| Conclusion and Recommendation| References|