Comparative Evaluation of Single Level Paravertebral Block Versus Caudal Block for Postoperative Analgesia in Pediatric Inguinal Surgery

Background and Aims: To compare and evaluate the efficacy of Single Level Paravertebral Block (SLPVB) with Caudal Block (CB) using 0.2% ropivacaine. Materials and Methods: A prospective study was performed for 40 children aged 2-8 years, undergoing paediatric inguinal hernia repair. They were divided into 2 groups, of 20 patients each, and SLPVB or CB was administered. They were followed up for 24hours and assessed for efficacy of the block in terms of duration of analgesia and quality of block as assessed by FLACC score. The amount of rescue analgesia used, parent satisfaction, and complications if any were also noted. The data collected was analyzed using SPSS software version 17 and a P value of <0.05 was considered significant and appropriate tests were applied. Results: The mean duration of action was found to be 1001.25±564.34 minutes (Median 1440 and IQR 975 minutes) in CB and 1440 minutes (Median 1440 IQR 0) in the PVB. This was statistically significant (P value = 0.03). The efficacy of the block as assessed by the FLACC score was comparable in the two groups. Rescue analgesia was required in 8 patients in the CB as compared to none in the PVB. The parent satisfaction levels were also significantly higher with PVB as compared to CB. No complications were noted with PVB. Failure of block occurred in 1 patient with CB, and there was complaint of urinary retention in 3 patients in the same group. Conclusion: SLPVB has been demonstrated to be superior to CB to provide postoperative analgesia children undergoing inguinal hernia surgery.