Comparison of Caudal Block versus General Anaesthesia in Paediatric Infraumbilical Surgeries

Background: Postoperative pain after paediatric infraumbilical surgery can delay recovery and increase agitation. Caudal block provides segmental analgesia for subumbilical procedures and can reduce systemic analgesic requirements. The objective is to compare caudal block with general anaesthesia in terms of haemodynamic stability, postoperative pain, rescue analgesic need, recovery profile and adverse events in children undergoing elective infraumbilical surgeries. Material and Methods: In this prospective comparative study, 60 children at Kamineni Institute of Medical Sciences, Narketpally, Telangana, India, from August 2024 to July 2025 were divided into Group C (caudal block, n=30) and Group G (general anaesthesia, n=30). Demographic profile, intraoperative heart rate, mean arterial pressure, FLACC scores, rescue analgesia, recovery time and complications were recorded. Results: Baseline characteristics and duration of surgery were comparable. At 15 and 30 minutes after incision, heart rate and mean arterial pressure were lower in Group C. FLACC scores at 30 minutes, 1 hour, 2 hours and 4 hours were significantly lower in Group C. Time to first rescue analgesia was longer with caudal block (348.6 ± 61.4 minutes) than with general anaesthesia (96.8 ± 28.7 minutes). Recovery time, emergence agitation and postoperative nausea/vomiting were also lower in Group C. Conclusion: Caudal block provided superior early postoperative analgesia, smoother recovery and fewer minor adverse events than general anaesthesia alone, while maintaining perioperative safety in paediatric infraumbilical surgeries.

Keywords: Caudal block; General anaesthesia; Paediatric anaesthesia; Infraumbilical surgery; FLACC score; Postoperative analgesia; Emergence agitation.