Comparison of Ultrasound Guided with Conventional Landmark Technique Caudal Block in Pediatric Patients Scheduled for Lower Abdomen Surgery under General Anesthesia: A Prospective Randomized Study

Shriram Gautam; Rajesh Sood; Rupesh Yadav; Sandeep Kumar

doi:10.18502/aacc.v9i2.12509

Shriram Gautam Department of Anaesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India.
Rajesh Sood Department of Anaesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India.
Rupesh Yadav Department of Anaesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India.
Sandeep Kumar Department of Anaesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India.

DOI: https://doi.org/10.18502/aacc.v9i2.12509

Keywords: Analgesia; Ultrasound; Pain; Abdomen

Abstract

Background: Perioperative pain in pediatric population is a special concern and Caudal block is easy to perform extensively safe if used in children, resulting in low pain scores and when combined with general anaesthesia, it reduces the requirement for volatile agents, opioids, improved postoperative analgesia, and earlier extubation. Ultrasound guided caudal block has reduced the complication rates such as inadvertent dural or vascular puncture. Aim of the study was to compare the success rate of ultrasound guided with conventional landmark technique caudal block in pediatric patients undergoing lower abdominal surgery under general anaesthesia.

Methods: Hundred pediatric patients, ASA class I, age between 6 months to 7 years of either sex, posted for lower abdomen surgery under general anaesthesia were randomly divided in to two groups. In group C- The group with caudal block using conventional landmark technique was used and Group U- The group with caudal block using ultrasound technique was used. Primary objectives of the study to find out the success rate of block in both the groups.

Results: The demographic data were comparable in group C and group U. Significant difference was seen in the distribution of successful block between group C and group U. (p value 0.008) block was successful in 96% of patients in group U which was significantly higher as compared to group C (76%). significant difference was seen in the distribution of number of attempts between group C and group U. (p value 0.001).

Conclusion: We conclude that Caudal block by ultrasound technique increases the first puncture success rate, decreases the number of multiple needle puncture attempts and overall success rate when compared to the conventional landmark technique in pediatric patients undergoing lower abdomen surgery.