الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Postoperative pain management in pediatric patients undergoing lower abdominal surgeries is important for medical and ethical reasons. Postoperative pain management increases patient satisfaction and decreases the period of hospital stay. In pediatric anesthesia, good and long-lasting analgesia is essential to achieve happy children and satisfied parents. To guarantee this, many pediatric anesthetists include a variety of regional anesthetic techniques in their daily clinical practice. Regional anesthesia is a safe and effective method of analgesia, especially as a supplement to general anesthesia.
QLB is an emerging technique for peripheral nerve blockade, which generates an analgesic effect by blocking spinal nerves from T6–T9 to L1-L3, considering its wide block range, it has been increasingly used for postoperative analgesia in patients undergoing middle and lower abdominal surgeries, and showed satisfactory. A single caudal injection of neostigmine 2 mcg/kg when added to bupivacaine 0.25% found to provide an extended duration of postoperative analgesia (≈20–22 h), and reduced the need for supplementary analgesics in children undergoing lower abdominal surgery. This duration is almost equal to the duration of analgesia provided by caudal bupivacaine co‐administered with neostigmine.
Neostigmine was one of the additives. Several studies have been performed to test its efficacy and safety. The addition of neostigmine to caudal bupivacaine prolonged the duration of postoperative analgesia after lower abdominal surgery. The dose of neostigmine selected in the current study (2μg/kg) was previously reported to provide effective analgesia with minimal side effects and reduce additional analgesics.
The aim of this study was to compare the postoperative pain control in children undergoing lower abdominal surgeries receiving QL block with those receiving caudal bupivacaine/ neostigmine.
Pediatric patients were randomly assigned into one of the following groups using computer generated codes and opaque sealed envelopes: QLB group received bilateral ultrasound guided QLB while CB group received bilateral ultrasound guided CB.
The study demonstrated that QLB has a superior analgesic effect than CB with prolonged analgesic effect.