Comparison of the Postoperative Analgesic Effects of RSB and CEB in Pediatric Patients Scheduled for Percutaneous Internal Ring Suturing

Diskapi Yildirim Beyazit Training and Research Hospital

Status: Enrolling

Conditions: Pain Management; Percutaneous Internal Ring Suturing

Treatments: Procedure: Rectus Sheath Block; Procedure: Caudal Epidural Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07147062

AEŞH-EK-2025-170

Details and patient eligibility

About

Inguinal hernia is one of the most common surgical pathologies in children, and the minimally invasive percutaneous internal ring suturing (PIRS) technique is widely preferred.

By providing effective pain control, nerve blocks reduce postoperative opioid requirements, thereby minimising opioid-related adverse effects and lowering the risk of pulmonary and cardiovascular complications.

This study aims to compare the postoperative analgesic effects of rectus sheath block and caudal epidural block in pediatric patients undergoing PIRS.

Enrollment: 65 estimated patients

Sex: All

Ages: 1 to 8 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged between 1 and 8 years
• ASA physical status I-II
• Patients who underwent PIRS surgery in the operating room and received either a rectus sheath block or a caudal epidural block

Exclusion criteria

• Patients younger than 1 year or older than 8 years
• ASA physical status ≥ III
• History of bleeding diathesis

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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65 participants in 2 patient groups

Rectus Sheath Block

Active Comparator group

Description:

Using an in-plane approach from cephalad to caudal, a 22G, 50-mm needle will be advanced through the subcutaneous tissues, penetrating the anterior rectus sheath and progressing within the muscle until the needle tip contacts the posterior rectus sheath. After negative aspiration, a total volume of 0.5 mL/kg of 0.25% bupivacaine-distributed equally between both sides-will be injected bilaterally under direct ultrasound guidance. Paracetamol at a dose of 10 mg/kg will be administered intraoperatively.

Treatment:

Procedure: Rectus Sheath Block

Caudal Epidural Block

Active Comparator group

Description:

A 22G caudal epidural needle will be inserted at approximately a 45° angle toward the sacral hiatus, and the characteristic "click" sensation will be felt upon passing the sacrococcygeal ligament. The needle will then be advanced carefully in the cephalad direction, parallel to the longitudinal axis of the spinal canal. After confirming correct placement by negative aspiration, 1 mL/kg of 0.25% bupivacaine will be administered. Paracetamol at a dose of 10 mg/kg will be administered intraoperatively.

Treatment:

Procedure: Caudal Epidural Block