Comparative Study Between US Guided Erector Spinae and US Guided Cudal Epidural Block

Comparative Study Between US Guided Erector Spinae and US Guided Cudal Epidural Block in Paediatric Unilateral Inguinal Hernia Repair Adjuvant to General Anaesthesia

Inguinal hernia is a common condition requiring surgical repair in the pediatric age group. The incidence of inguinal hernias is approximately 3% to 5% in term infants and 13% in infants born at less than 33 weeks of gestational age. Inguinal hernias in both term and preterm infants are commonly repaired shortly after diagnosis to avoid incarceration of the hernia. Given the lack of definitive data, optimal timing for repair of inguinal hernias in infants remains debatable[1].

: An erector spinae plane block is a relatively new regional anesthetic technique. Apart from case reports and small series, the literature regarding pediatric use is limited.

The first author to describe caudal anaesthesia as applied to children (here in connection with urologic surgical procedures) was Meredith Campbell in 1933.(2) Over time, this idea has developed into a technique of great interest, especially for use in premature infants and in newborns, considering that these paediatric subgroups are, as a result of an immature state of the CNS, at high risk of perioperative respiratory depression.

This study will be conducted to compare caudal versus ESPB as regard intraoperative and postoperative analgesia in unilateral inguinal hernia and the feasibility of ESPB in paediatric patient.

Inclusion Criteria:

• age 3 moonths 6 years old
• American Society of Anesthesiologists physical status I, II for non complicated inguinal hernia.

Exclusion Criteria:

• Patients with a sepsis
• malignancy anywhere
• patient with bleeding tendencies or on anticoagulation therapy,
• allergy to study drugs
• congenital anomalies
• delayed motor or developmental milestones