Comparison of caudal and retrolaminar blocks for postoperative analgesia in pediatric orchidopexy: A randomized controlled trial

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dc.authorid0000-0002-2714-9046
dc.authorid0000-0002-4305-5226
dc.authorid0000-0001-7447-5074
dc.authorid0009-0007-5579-1670
dc.authorid0000-0003-4962-9398
dc.authorid0000-0002-3245-6614
dc.authorid0000-0003-4739-6623
dc.contributor.authorÖzen, Volkan
dc.contributor.authorUmutoğlu, Tarık
dc.contributor.authorTuran, Engin İhsan
dc.contributor.authorAyas, Tahir Arda
dc.contributor.authorYiğit, Doğakan
dc.contributor.authorÇiftçi, Bahadır
dc.contributor.authorAlver, Selçuk
dc.date.accessioned2026-04-16T08:03:28Z
dc.date.available2026-04-16T08:03:28Z
dc.date.issued2026
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
dc.description.abstractBackground: Lower abdominal surgeries in children are associated with significant postoperative pain. While caudal block (CB) is widely used, ultrasound-guided truncal blocks such as retrolaminar block (RLB) may provide more targeted and prolonged analgesia. METHODS: In this double-blind, randomized controlled trial conducted at two tertiary hospitals (March 1-September 1, 2025), children aged 1-7 years (ASA I-II) scheduled for unilateral orchidopexy were randomized to RLB or CB. CB received 0.125% bupivacaine 1 mL/kg (max 20 mL); RLB received 0.25% bupivacaine 0.1 mL/kg, both under standardized general anesthesia with intraoperative IV paracetamol (10 mg/kg). FLACC scores were recorded at 30 min and 1, 2, 4, 6, 12, and 24 h. Rescue analgesia was IV paracetamol for FLACC 2-4 and IV tramadol for FLACC >4. Primary outcome was analgesic efficacy (FLACC at 12th hour). Secondary outcomes were time to first analgesic and total consumption within 24 h. RESULTS: Sixty-two patients were analyzed (N.=31 per group); baseline demographics did not differ. RLB yielded lower FLACC scores at 6 h (P=0.002), 12 h (P=0.007), and 24 h (P=0.018), with no difference at 30 min or 1 h (P>0.05). Time to first analgesic was longer with RLB (P<0.001), and total 24-h consumption was lower (P=0.001). Fewer patients required rescue analgesia with RLB (3/31) than CB (14/31). No major block-related complications occurred. CONCLUSIONS: In pediatric orchidopexy, RLB provided superior and more durable analgesia than CB, reduced 24-h analgesic requirements, and delayed first rescue dosing without major complications, supporting its role within opioid-sparing pediatric ERAS pathways.
dc.identifier.citationÖzen, V., Umutoğlu, T., Turan, E. İ., Ayas, T. A., Yiğit, D., Çiftçi, B., & Alver, S. (2026). Comparison of caudal and retrolaminar blocks for postoperative analgesia in pediatric orchidopexy: A randomized controlled trial. Minerva Anestesiologica, https://doi.org/10.23736/S0375-9393.25.19579-5
dc.identifier.doi10.23736/S0375-9393.25.19579-5
dc.identifier.issn0375-9393
dc.identifier.issn1827-1596
dc.identifier.pmidPMID: 41884978
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.23736/S0375-9393.25.19579-5
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1414
dc.identifier.wosWOS:001730331200001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorUmutoğlu, Tarık
dc.institutionauthorid0000-0002-4305-5226
dc.language.isoen
dc.publisherEdizioni Minerva Medica S.p.A.
dc.relation.ispartofMinerva Anestesiologica
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectAnesthesia
dc.subjectConduction
dc.subjectPediatric Anesthesia
dc.subjectCaudal
dc.titleComparison of caudal and retrolaminar blocks for postoperative analgesia in pediatric orchidopexy: A randomized controlled trial
dc.typeArticle
dspace.entity.typePublication

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