Özen, VolkanUmutoğlu, TarıkTuran, Engin İhsanAyas, Tahir ArdaYiğit, DoğakanÇiftçi, BahadırAlver, Selçuk2026-04-162026-04-162026Özen, 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/S0375-9393.25.19579-50375-93931827-1596https://doi.org/10.23736/S0375-9393.25.19579-5https://hdl.handle.net/20.500.13055/1414Background: 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.eninfo:eu-repo/semantics/closedAccessAnesthesiaConductionPediatric AnesthesiaCaudalArticle10.23736/S0375-9393.25.19579-5Q1WOS:001730331200001PMID: 41884978Q2