الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
In recent years, awareness of the value of adequate postoperative pain relief has been increased and several methods have been introduced in modern paediatric anaesthesia.
Regional anaesthesia produces excellent postoperative analgesia and attenuation of the stress response in infants. US guided truncal blocks as QLB can offer an effective component of multimodal analgesia with limited side effects.
Caudal neuroaxial block plays a crucial role in paediatric anaesthesia for most operations (e.g., inguinal hernia repair, hydrocoele, orchidopexy, circumcision, lower limb orthopedic procedures, anorectal interventions) in addition to its role in specific types of abdominal and thoracic surgery.
In the light of the previously mentioned information, this study was intended to compare these two common techniques in regional anaesthesia for the paediatric colonic surgeries regarding the analgesic effect, duration of postoperative analgesia and any side effects.
This study was carried out in Paediatric Surgery Department in El-Shatby Hospital on 60 children of both sexes aged (1- 5 years) evaluated as ASA I or II physical status undergoing abdominal colonic surgery. Patients were randomly categorized into two equal groups 30 children each: group Q (n=30) received bilateral US guided QLB, and group C (n=30) received US guided caudal block using 1 mL/kg 0.25% levobupivacaine.
All patients were evaluated the day before surgery with proper history
taking and clinical examination. All parents were informed about the QL and caudal blocks, and a written consent was obtained.
Premedication was done using oral midazolam at 0.5 mg/kg in 10 ml clear juice or water 30 min before surgery. On arrival to operating theatre, they were attached to a multichannel monitor (Dräger vista 120) to display continuous ECG, noninvasive BP, and peripheral oxygen saturation (SpO2).
Inhalational induction was carried out with every single breath using incremental concentrations of sevoflurane in 3 L/min O2 50% in air via face mask. A 24 G cannula was inserted in a peripheral vein. Fentanyl (2mcg/kg) and atracurium 0.5 mg/kg were given with induction.
Endotracheal tube was inserted and confirmed by chest auscultation of bilateral equal air entry and a normal capnographic waveform and anaesthesia was maintained by oxygen and sevoflurane 2% with mechanical ventilation. Bolus IV lactated Ringer’s solution was given at the dose of 10 ml/Kg.
All blocks were performed by the same anaesthesiologist using a high frequency linear probe (6–10 MHz) of the ultrasound Mindray DP-20 device. Blocks were performed after induction and before any surgical stimulation.
The following parameters were assessed; demographic data, haemodynamic measurements, postoperative pain degree (using FLACC scale), duration of postoperative analgesia, total requirements of rescue analgesia, block execution time, duration and type of surgery, and any side effects