Ultrasound-guided caudal block versus supra inguinal fascia iliac block for pain management in paediatric hip surgery: A randomised, double-blind comparative study
Indian J Anaesth. 2026 Jan;70(1):229-235. doi: 10.4103/ija.ija_217_25. Epub 2026 Jan 2.
ABSTRACT
BACKGROUND AND AIMS: Regional anaesthetic techniques are widely used for postoperative analgesia in paediatric hip and femur surgeries. Caudal blocks, while effective, require precise anatomical knowledge and can be time-consuming with potential complications. The suprainguinal fascia iliaca block (FICB) offers a potentially simpler and safer alternative. This study aimed to compare the analgesic efficacy of ultrasound guided caudal block and suprainguinal FICB in children undergoing hip surgery.
METHODS: This randomised, double-blind study included 60 paediatric patients aged 2-8 years undergoing unilateral hip surgery. Participants were assigned to either Group A (caudal block) or Group B (suprainguinal FICB). The primary outcome of this study was to compare the postoperative pain intensity using the FLACC (Face, Legs, Activity, Cry, Consolability) scale assessed at 4 h postoperatively. The secondary outcomes were to assess pain scores at additional time intervals (30 minutes, 2, 6, 12, and 24 h), evaluate the time first to rescue analgesia, and compare the total number of analgesic doses administered within the first 24 h postoperatively. Data were analysed using SPSS Version 22.0 and compared using Student's independent samples t-test.
RESULTS: At 4 h postoperatively, FLACC scores were comparable between both groups (P > 0.05), indicating no significant difference in peak pain intensity. FLACC scores at additional time intervals (30 minutes, 2, 6, 12, and 24 h) were also statistically similar. However, the time to first rescue analgesic was significantly longer in Group B (14.3 h) than in Group A (10.0 h; P = 0.043), suggesting more prolonged analgesia in the FICB group. Although not statistically significant, the average number of rescue doses was slightly higher in Group A (2.32) compared to Group B (2.00).
CONCLUSION: Suprainguinal FICB provides analgesia comparable to caudal block, with a longer duration before requiring rescue analgesia.
PMID:41696370 | PMC:PMC12900196 | DOI:10.4103/ija.ija_217_25