scholarly journals Can Ultrasound-Guided Nerve Block Be A Useful Method Of Anesthesia For Tumor Surgery In The Foot And Ankle

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Gi-Soo Lee ◽  
Byung Hak Oh ◽  
Chan Kang ◽  
Yougun Won ◽  
Yoo Jung Park ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
General Anesthesia ◽  
Pain Score ◽  
Nerve Block ◽  
Safe Procedure ◽  
Tumor Surgery ◽  
Block Group ◽  
Foot And Ankle ◽  
Ultrasound Guided ◽  
Anesthetic Effect

Category: Ankle, Tumor Introduction/Purpose: Tumors arising in the foot and ankle are often need surgical treatment. However, there is hesitation about the surgical treatment of anxiety about general anesthesia in some patients. Ultrasound-guided nerve block can be a useful method of anesthesia for tumor surgery in the foot and ankle.This study was performed to compare general anesthesia and ultrasound (US)-guided nerve block for tumor surgery in the foot and ankle. Also, whether US-guided nerve block is a useful method of anesthesia for tumor surgery was investigated. Methods: In this prospective, randomized study, 50 patients who underwent tumor surgery between February 2013 and February 2016 were allocated to two groups: general anesthesia (n = 25, or US-guided nerve block (n = 25). All patients completed a questionnaire with three questions 2 weeks after surgery. For the nerve block group, the procedure duration, interval between the procedure and onset of the anesthetic effect, the point of loss of the anesthetic effect, intraoperative, postoperative visual analog scale (VAS) pain score, and discomfort during surgery were assessed. Results: There was no patient in which the anesthetic was changed to another method during the operation. VAS pain score of postoperative 1 and 6 h was significantly different between the nerve block group (2.2 ± 1.5 and 3.0 ± 1.8, respectively) and general anesthesia group (5.2 ± 3.9 and 5.4 ± 4.5, respectively) Twenty three US-guided nerve block (92%) and 17 general anesthesia patients (68%) reported that they would prefer the same type of anesthesia if they were to undergo tumor surgery in the foot and ankle again; these differences were significant (P < 0.05). There were no long-term complications, such as neurological deficits or infection, after the procedure in all patients. Conclusion: Tumor surgery, such as tumor excision or biopsy, amputation, and other procedures, was performed safely and effectively under US-guided nerve block. These results indicated that US-guided nerve block for tumor surgery is a highly satisfactory and safe procedure without complications and is available for use by any orthopedist.

scholarly journals A Comparative Study between Effects of Ultrasound Guided Ilioinguinal /Iliohypogastric Nerve Block versus Caudal Block on Postoperative Analgesia in Children Undergoing Inguinal Surgery

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M H Nafie ◽  
W A Altaher ◽  
G N Nassef ◽  
M M W Ahmed
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
General Anesthesia ◽  
Nerve Block ◽  
Pain Control ◽  
Block Group ◽  
Caudal Block ◽  
Ultrasound Guided ◽  
Intravenous Morphine ◽  
Caudal Epidural

Abstract Background The most commonly performed inguinal surgeries in children include inguinal hernia repair with or without orchidopexy and hydrocele repair. For postoperative pain with these surgeries, a regional analgesic modality such as caudal analgesia (CA), ilioinguinal and iliohypogastric nerve block (IL/IH), or even local infiltration is combined with a general anaesthetic (GA). Regional analgesia techniques are commonly used to facilitate pain control during pediatric surgical practice, decrease parenteral opioids requirements and improve the quality of post-operative pain control and patient-parent satisfaction. When compared to intravenous (IV) opioids, regional techniques reduce the risk of side effects such as somnolence, respiratory depression, emesis, and ileus. Patients and Methods: After approval of anesthesia, intensive care and pain management department, scientific and ethical committees, and after informed parental written consents, this prospective randomized clinical trial study was conducted in Ain Shams University Hospitals. This study is considered to be a pilot exploratory study. Forty five children patients were included in the study scheduled for elective inguinal surgeries (e.g.; unilateral inguinal hernia repair, hydrocele repair, or orchidopexy). Patients will be randomized using a random number table and the use of a closed envelopes technique to receive either combined general anesthesia with ultrasound guided caudal block (Group A), combined general anesthesia and ultrasound guided ilioinguinal /iliohypogastric block (Group B), or general anesthesia with intravenous morphine (group C). Results Among 45 children of (27 boys and 18 girls), aged from one to six years old, ASA physical status I–II who were scheduled for elective unilateral inguinal surgeries, fifteen patients received general anesthesia with ultrasound guided caudal epidural anesthesia (1ml/kg bupivacaine 0.25%), fifteen patients received general anesthesia with ultrasound-guided ilioinguinal/ iliohypogastric nerve block (0.5ml/kg bupivacaine 0.25%) and fifteen patient received general anesthesia with intravenous morphine (0.1 mg/kg). Conclusion The current study demonstrated that ultrasound-guided ilioinguinal /iliohypogastric nerve block was more effective than ultrasound guided caudal epidural block or intravenous morphine usage in children aged 1-6 years old undergoing unilateral inguinal surgeries as it carried the advantages of faster onset of action, longer duration of postoperative analgesia, the need of lower volumes of local anesthetic agents with no recorded complications.

scholarly journals Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails

2021 ◽  
Vol 18 (10) ◽  
pp. 5059
Author(s):  
Beom Suk Kim ◽  
Kyungho Kim ◽  
Jonathan Day ◽  
Jesse Seilern Und Seilern Und Aspang ◽  
Jaeyoung Kim
Keyword(s):  
Surgical Treatment ◽  
Adverse Events ◽  
Nerve Block ◽  
Skin Penetration ◽  
Sensory Block ◽  
Foot And Ankle ◽  
Ingrown Toenail ◽  
Ankle Surgery ◽  
Ingrown Toenails ◽  
Digital Nerve Block

Background: Digital nerve block (DB) is a commonly utilized anesthetic procedure in ingrown toenail surgery. However, severe procedure-related pain has been reported. Although the popliteal sciatic nerve block (PB) is widely accepted in foot and ankle surgery, its use in ingrown toenail surgery has not been reported. Therefore, this study aimed to investigate the safety and effectiveness of PB in the surgical treatment of ingrown toenails. Methods: One-hundred-ten patients surgically treated for an ingrown toenail were enrolled. Sixty-six patients underwent DB, and 44 underwent PB. PB was performed under ultrasound-guidance via a 22-gauge needle with 15 mL of 1% lidocaine in the popliteal region. The visual analogue scale was used to assess pain at two-time points: pain with skin penetration and pain with the solution injection. Time to sensory block, duration of sensory block, need for additional injections, and adverse events were recorded. Results: PB group demonstrated significantly lower procedure-related pain than the DB group. Time to sensory block was significantly longer in the PB group (20.8 ± 4.6 versus 6.5 ± 1.6 minutes). The sensory block duration was significantly longer in the PB group (187.9 ± 22.0 versus 106.5 ± 19.1 minutes). Additional injections were required in 16 (24.2%) DB cases, while no additional injections were required in PB cases. Four adverse events occurred in the DB group and two in the PB group. Conclusion: PB was a less painful anesthetic procedure associated with a longer sensory block duration and fewer repeat injections compared with DB. The result of this study implicates that PB can be an alternative anesthetic option in the surgical treatment of ingrown toenails.

Efficacy of combined ultrasound guided Pectoral Nerve Block (PECS I block and PECS II block) using Bupivacaine with or without Magnesium Sulfate in modified radical mastectomy under general anathesia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Salwa Omar El-Khattab ◽  
Mohamed Osman Taeimah ◽  
Mahmoud Mohamed Elsayed Seif
Keyword(s):  
General Anesthesia ◽  
Magnesium Sulfate ◽  
Nerve Block ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Recording Time ◽  
Female Population ◽  
Pectoral Nerve ◽  
Group I

Abstract Background Breast cancer has continued to be the most common cancer afflicting women, accounting for 31% of all new cancer cases in the female population. Every year, thousands of patients undergo surgery in the region of the breast and axilla. Surgery is one of the mainstays of treatment, and a procedure called modified radical mastectomy (MRM) is now a standard surgical treatment for early-stage breast cancers. Objective To evaluate the Efficacy of combined ultrasound guided Pectoral Nerve Block (PECS I block and PECS II block) using Bupivacaine with or without Magnesium Sulfate in modified radical mastectomy under general anathesia. Patients and Methods After obtaining approval from the medical ethical committee in Ain Shams University This study was conducted in the operating theatres of Ain Shams University Hospitals. It included Thirty Female patients undergoing Modified Radical Mastectomy were divided randomly into two groups, each group consisted of 25 patients group I in which patients received general anesthesia followed by PECS BLOCK using only bupivacaine 0.25 % and group II in which patients received general anesthesia followed by PECS BLOCK using bupivacaine 0.25 % plus magnesium sulfate 50% (200mg). Results The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first for analgesic need and total consumption of opioid and analgesic in the 1st 24 postoperative hours. Demographic data and post operative hemodynamics were also assessed. Conclusion The addition of 200 mg of magnesium sulfate to bupivacaine in an ultrasound-guided Pectoral Nerve Block significantly reduce postoperative opioid consumption, prolong the duration of the analgesia, and reduce the VAS score without significant side effects after Modified Radical Mastectomy under general anesthesia.

scholarly journals A Pilot Randomised Clinical Trial of 3-In-1 Femoral Nerve Block and Intravenous Morphine as Primary Analgesia for Patients Presenting to the Emergency Department with Fractured Hip

2008 ◽  
Vol 15 (4) ◽  
pp. 205-211 ◽  
Author(s):  
CA Graham ◽  
K Baird ◽  
AC McGuffie
Keyword(s):  
Emergency Department ◽  
Pain Score ◽  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Wilcoxon Test ◽  
Block Group ◽  
Pain Scores ◽  
Significant Difference ◽  
Median Pain

Background Fractured neck of femur (NOF) is a leading cause of morbidity and mortality in the elderly. Published clinical guidelines suggest early adequate analgesia as a key management aim. The femoral nerve ‘3-in-1 block’ has previously been shown to provide effective analgesia for these patients in the peri- and post-operative phase of care. The aim of this study was to examine the use of the ‘3-in-1’ femoral nerve block as primary analgesia for patients with a fractured NOF presenting to the emergency department. Methods This was a single centre pragmatic randomised controlled open-label trial comparing femoral nerve block (using a ‘3-in-1’ technique) with intravenous (IV) morphine. A convenience sample of patients presenting to the emergency department of a district general hospital with a clinically or radiologically suspected fractured NOF were recruited. They were randomised to receive either 0.1 mg/kg IV bolus of morphine or a ‘3-in-1’ femoral nerve block with 30 ml of 0.5% plain bupivacaine. Visual analogue pain scores were noted prior to treatment and at 30 minutes, 2 hours, 6 hours and 12 hours after treatment. Immediate complications such as vascular puncture or the requirement for naloxone were noted. Results Forty patients were recruited, 22 patients were randomised to IV morphine and 18 patients were randomised to ‘3-in-1’ femoral nerve block. Complete data were available for 33 patients. There was no significant difference in initial median pain score (p=0.45). Analysis using the Wilcoxon test showed a significant decrease in pain score for the morphine group (p=0.01) and the nerve block group (p<0.01) at 30 minutes compared with baseline. Analysis using the Mann-Whitney U test between median pain scores at each time point showed a significant lower pain score in the nerve block group at 30 minutes (p=0.046). There were no immediate complications in either group. Conclusion Our results suggest that a ‘3-in-1’ femoral nerve block is at least as effective as IV morphine when used as primary analgesia for patients with fractured NOF. Our results suggest that the femoral nerve block may provide better analgesia at 30 minutes. Further larger scale randomised trials are warranted.

scholarly journals Liposomal Bupivacaine versus Continuous Popliteal Nerve Block in Total Ankle Arthroplasty

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Ryan Mulligan ◽  
Joel Morash ◽  
James DeOrio ◽  
Selene Parekh
Keyword(s):  
Postoperative Pain ◽  
Sciatic Nerve ◽  
Pain Score ◽  
Nerve Block ◽  
Total Ankle Arthroplasty ◽  
Sciatic Nerve Block ◽  
Foot And Ankle ◽  
Ankle Arthroplasty ◽  
Ankle Surgery ◽  
Regional Anesthetic

Category: Ankle, Ankle Arthritis Introduction/Purpose: The use of liposomal bupivacaine (LB) has recently gained popularity in joint arthroplasty. Despite it’s proven safety and efficacy, there is little reported on the use of LB in foot and ankle surgery. Catheter placement for a continuous popliteal sciatic nerve block (CPSNB) has an excellent track record for pain relief, and is commonly used by our group for major foot and ankle reconstructions. The purpose of this study was to compare the use of intraoperative LB injection to CPSNB as a regional anesthetic for total ankle arthroplasty (TAA), with attention to postoperative pain scores, narcotic use, and complications. Methods: Retrospective review of TAA patients treated by two fellowship-trained orthopedic foot and ankle surgeons was performed. Patient demographic data, operative, and postoperative details were collected, including type of regional anesthetic used. Patient’s received either preoperative single-shot popliteal sciatic nerve block with 0.25% bupivacaine followed by intraoperative injection of LB, or preoperative CPSNB alone. Outcomes examined were VAS pain score at 8 hours, 24 hours, 1 week, and 3 weeks following surgery, need for opioid pain medication refill, physician office notification for pain issues or other adverse events, and complications within the first 90 days following surgery. Standard statistical analysis was performed and p < 0.05 was considered significant. Results: 75 patients were identified who underwent TAA and met inclusion criteria. 41 received LB and 34 received CPSNB. No statistical difference was seen between groups with regard to complications, emergency department visits, readmissions, reoperations, VAS pain score at any time point, physician office contacts, and narcotic refills. Mean VAS with LB use was 1.8, 3.5, 2.6, and 2.2 at 8 hours, 24 hours, 1 week, and 3 weeks respectively, compared with mean VAS 2.1, 3.2, 2.2, and 1.9 at similar time points for CPSNB (p=0.59, 0.65, 0.27, and 0.40, respectively). 16 of 41 LB patients needed narcotic refills, versus 12 of 34 CPSNB patients (p=0.81). 3 of 41 LB patients had a complication postoperatively, versus 4 of 34 CPSNB patients. Conclusion: This is the first study evaluating the use of LB for total ankle arthroplasty. LB was both safe and effective for postoperative pain control, with comparable results to CPSNB. As LB gains more widespread use in foot and ankle surgery, further investigation is warranted to determine potential unseen complications and cost-effectiveness.

scholarly journals Ultrasound-guided internal branch of superior laryngeal nerve block on postoperative sore throat: A randomized controlled trial

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241834
Author(s):  
Li Zhipeng ◽  
He Meiyi ◽  
Wang Meirong ◽  
Jiang Qunmeng ◽  
Jia Zhenhua ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Sore Throat ◽  
Nerve Block ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Secondary Outcome ◽  
Ultrasound Guided ◽  
Postoperative Sore Throat ◽  
Internal Branch ◽  
Group I

Introduction Ultrasound-guided internal branch of the upper laryngeal nerve block (USG-guided iSLN block) have been used to decrease the perioperative stress response of intubation. It is more likely to be successful than blindly administered superior laryngeal nerve blocks with fewer complications. Here, we evaluated the efficacy of USG-guided iSLN block to treat postoperative sore throat (postoperative sore throat, POST) after extubation. Methods 100 patients, aged from 18 to 60 years old, ASA I~II who underwent general anesthesia and suffered from the moderate to severe postoperative sore throat after extubation were randomized into two groups(50 cases per group). Patients in group S received USG-guided iSLN block bilaterally (60mg of 2% lidocaine, 1.5ml each side), whereas those in group I received inhalation with 100 mg of 2% lidocaine and 1mg of budesonide suspension diluted with normal saline (oxygen flow 8 L /min, inhalation for 15 minutes). The primary outcome were VAS scores in both groups before treatment (T0), 10 min (T1), 30 min(T2), 1h(T3), 2 h(T4), 4h(T5), 8h(T6), 24h(T7), and 48h(T8) after treatment. The secondary outcome were satisfaction scores after treatment, MAP, HR, and SPO2 fromT0 to T8. The adverse reactions such as postoperative chocking or aspiration, cough, hoarseness, dyspnea were also observed in both groups. Results Patients in group S had significantly lower VAS score than that in group I at points of T1 ~ T6 (P < 0.01). HR of group S was lower than that of group I at points of T1 ~ T2and T4 (P < 0.05), and MAP was lower than that of group I at points of T1 ~ T3 (P < 0.05). Satisfaction scores of group S were higher than that of group I (P <0.05), In group S, 2 case (4%) needed to intravenous Flurbiprofen Injection 50 mg to relieve pain; in group I, 13 cases (26%) received Flurbiprofen Injection. 2 case of group S appeared throat numbness after treatment for 3 hours; 2 patients have difficult in expectoration after treatment recovered after 3hour. No serious adverse events were observed in both groups. Conclusion Compared with inhalation, USG-guided iSLN block may effectively relieve the postoperative sore throat after extubation under general anesthesia and provided an ideal treatment for POST in clinical work.

scholarly journals Ideal Anatomic Location for Saphenous Nerve Block for Foot and Ankle Surgeries: A Prospective Randomized Clinical Evaluation

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Karl Henrikson ◽  
Sanjib Adhikary ◽  
Gregory Pace ◽  
Wai Liu ◽  
Paul Juliano ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Score ◽  
Nerve Block ◽  
Knee Extension ◽  
Saphenous Nerve ◽  
Foot And Ankle ◽  
Nerve Blocks ◽  
Knee Extension Strength ◽  
Significant Difference ◽  
Isometric Knee Extension

Category: Regional anesthesia for foot and ankle surgery Introduction/Purpose: Regional anesthesia has resulted in significant improvements in patient outcomes including reduced postoperative pain, opioid consumption, opioid-related adverse effects, and decreased postoperative length of stay. Saphenous nerve blocks provide distal analgesia while minimizing the reduction in quadriceps strength seen with more proximal femoral nerve blocks. Saphenous nerve blocks may be performed at the mid-thigh with the subsartorial technique or just proximal to the knee with the transsartorial technique. The present study compares these two techniques in terms of analgesia effectiveness and quadriceps motor preservation. Methods: This study was approved by our institutional IRB committee. A power analysis was conducted prior to the study. Patients, aged 18 to 65, were prospectively identified from a list of elective foot and ankle surgeries performed by one of the study investigators. Preoperatively, bilateral isometric knee extension strength was measured, and subjects completed a PROMIS global health survey. The surgeon was blinded to the randomization of patients to proximal or distal blocks. Bilateral isometric knee extension strength was reassessed following the block as well as sensation, post-operative visual analogue pain score (VAS), and subjective satisfaction. Due to non-normality of the sample, the Wilcoxon rank-sum test was employed to analyze continuous variables such as strength measures. For categorical variables such as gender, pain score, and patient satisfaction, the Pearson chi- square test was used. Results: Twenty-four patients (24 lower extremities) were enrolled in the study and 12 randomized to each group. The two groups were not significantly different in age, gender, or pre-operative PROMIS Mental and Physical Summary Scores. The nerve block procedure was successfully performed in a single attempt in all cases. The VAS was not significantly different at 2 in the distal group and 3 in the proximal group. In each group 11 patients were totally satisfied with the block and 1 was moderately satisfied. The knee extension strength decreased in both the operative and non-operative lower extremity following administration of the nerve block. When normalized to the effect in the non-operative extremity, there was no significant difference in strength decrease between the two groups (p=0.89). Conclusion: This randomized, single-blinded trial compared proximal subsartorial saphenous nerve block with distal transsartorial saphenous nerve block outside of the adductor canal. There was no significant difference in the efficacy of the two techniques was observed in terms of VAS pain score or patient satisfaction and no difference in post-operative weakness. This is the first randomized trial on saphenous nerve blocks to normalize strength to the non-operative lower extremity, reducing the confounding effect of peri-operative narcotic and sedative medications. This study offers evidence for equivalence of the subsartorial and transsartorial saphenous nerve block techniques.

scholarly journals Ultrasound-guided psoas compartment and sciatic nerve blocks for pain management of hind limb procedures in the alpaca (Vicugna pacos)

2020 ◽  
Vol 10 (2) ◽  
pp. 120-127
Author(s):  
Andrew Foster
Keyword(s):  
Sciatic Nerve ◽  
General Anesthesia ◽  
Nerve Block ◽  
Femoral Nerve ◽  
Standing Position ◽  
Sciatic Nerve Block ◽  
Anesthetic Techniques ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Vicugna Pacos

Background: Loco-regional anesthetic techniques are considered important in the multimodal approach to analgesia in both human and veterinary medicine. No such techniques are described in the alpaca, bar the use of epidural. This is in part due to the lack of anatomical description for this species. While this limitation exists, the use of ultrasound guidance makes peripheral nerve blocks a viable possibility in the alpaca.Case description: A 12-month-old alpaca was referred for the treatment of a septic left tarso-crural joint. Due to a poor prognosis, amputation of the limb under general anesthesia was performed. Sciatic and psoas compartment blocks were attempted with the ultrasound-guided injection of ropivacaine prior to the start of the procedure. While the femoral nerve was possible to visualize, no obturator nerve was identified. A 5-year old alpaca was also referred for a left hind lateral claw removal, due to a squamous cell carcinoma. The sciatic nerve block was performed prior to the claw amputation under general anesthesia. No changes in heart and respiratory rate, or blood pressure suggestive of nociception, were observed in either of these cases. At the end of both the procedures, the patients experienced uneventful recoveries characterized by the ability to maintain the standing position, interest in food, and normal behavior.Conclusion: This report identifies the ease of performance and the challenges encountered using the ultrasound guided psoas compartment and sciatic nerve blocks in the alpaca. It is our hope that this report encourages the use of ultrasound-guided loco-regional techniques in this species. Keywords: Alpaca, Loco-regional anesthesia, Psoas compartment block, Sciatic nerve block, Ultrasound-guided.

scholarly journals The Analgesic Efficacy of Ultrasound-Guided Quadratus Lumborum Block Versus Ultrasound-Guided Caudal Block for Hip Surgery in Pediatrics: A Prospective Randomized Study

2021 ◽  
pp. 58-68
Author(s):  
Islam M. Salim ◽  
Shimaa M. EL. Rahwan ◽  
Mohamed M. Abu Elyazd ◽  
Lobna M. Abo Elnasr
Keyword(s):  
General Anesthesia ◽  
Pediatric Patients ◽  
Randomized Study ◽  
Analgesic Efficacy ◽  
Surgical Correction ◽  
Nausea And Vomiting ◽  
Block Group ◽  
Caudal Block ◽  
Ultrasound Guided ◽  
Quadratus Lumborum

Background: Ultrasound-guided quadratus lumborum (QL) block, is local anesthetic technique providing perioperative somatic, perhaps even visceral, analgesia for patients of all ages. The aim of this study is to evaluate the analgesic efficacy of ultrasound-guided anterior QL block versus ultrasound-guided caudal block in pediatric patients undergoing hip surgery. Patients and Methods: This prospective, randomized study was carried out on seventy patients aged 1-7 years, of both with ASA physical status I or II scheduled for elective surgical correction of developmental dysplasia of hip (DDH). Anterior QL Block Group: Patients received ipsilateral ultrasound-guided anterior QL block after induction of general anesthesia using of bupivacaine 0.25% (0.5 mL/kg). Caudal Block Group: Patients received ultrasound-guided caudal block after induction of general anesthesia using of bupivacaine 0.25% (0.75 mL/kg). Postoperative pain scores were assessed on admission to PACU and at 1, 2, 4, 6, 8, 12, 18 and 24 h postoperative. Total intraoperative fentanyl (µg) consumption, total postoperative rescue analgesic (morphine) consumption, time to the first rescue analgesic administration and Parent satisfaction were assessed. Heart rate and mean arterial blood pressure had been recorded pre–operative, every 15 min intra-operative , and postoperative on admission to PACU and at 1, 2, 4, 6, 8, 12, 18 and 24 h postoperative. Any undesirable side effects during the first 24 hours such as, bradycardia, hypotension, local hematoma at the side of injection, nausea and vomiting had been recorded. Results: The median FLACC score was significantly lower in anterior QL block group than caudal block group at 4,6,8 and 12h postoperative (P<0.001). Total intraoperative fentanyl (µg) consumption was insignificant different between both groups (P=0.862). Post-operative morphine consumption was significantly lower in anterior QL group compared to caudal group (P<0.001). Time to first postoperative analgesic requirement was significantly prolonged in anterior QL block group compared to caudal block group (P < 0.001). The incidence of nausea and vomiting was insignificantly different between both groups (P > 0.999). Conclusions: Ultrasound-guided anterior QL block provided effective and long lasting postoperative analgesia than ultrasound-guided caudal block with lesser postoperative analgesic consumption in pediatric patients undergoing surgical correction of DDH.

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