Analgesic Effectiveness between Preemptive Intravenous Acetaminophen and Single-Shot Caudal Block in Paediatric Inguinal Hernia Repair

In an era where fast-track surgery is preferred and more cases are performed under day care surgery, anaesthesia techniques and pain management evolve to suit the demand.In our study, we compared the anal- gesic effectiveness between preemptive intravenous acetaminophen and single-shot caudal block in paediatric patients undergoing inguinal hernia repair.
This is a prospective randomised study involving a total of 40 American Society of Anesthesiologists (ASA) 1 and 2 patients who are 6 months to 5 years old, randomised into two groups: group A (intravenous aceta- minophen) and group B (single-shot caudal). Our primary outcome is the postoperative pain score using Face, Legs, Activity, Cry, and Consolability (FLACC) scale at several intervals (10 min, 30 min, 1 h, 2 h, and 6 h). The time of first rescue analgesic requirement was compared. The pain score of group B patients was lower during the first 1 h postoperatively (p = 0.018) at 10 min, (p = 0.013) 30 min, and (p = 0.05) 1 h and was found to be insignificant beyond the period. Nonetheless, the mean pain score in both groups was low with 0.15; lowest and 0.45; highest. We found no significant mean time difference for the first analgesic requirement and mean total opioid consumption between the two groups. Preemptive IV acetaminophen is equivocal to caudal block for a paediatric herniotomy surgery. In fact, IV acetaminophen could give more pharmacoeconomics advantages as it is easily administered, less time needed hence more rapid turnovers between the cases and high safety profile