الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
In recent years, awareness of the value of adequate postoperative pain relief has been increased and several methods have been introduced. An effective pain therapy to block or modify the physiologic responses to stress has become an essential component of modern pediatric anesthesia.
Ultrasound guidance for regional anesthesia is associated with higher block success rates, shorter onset times, and reduced total anesthetic dose required and reduced complications. There is also the advantage of direct observation of the pattern of local anesthetic spread.
Innervation of the anterolateral abdominal wall arises from the anterior rami of spinal nerves T7 to L1. Branches from the anterior rami include the intercostal nerves (T7-T11), the subcostal nerve (T12) and the iliohypogastric /ilioinguinal nerves (L1). Intercostal nerves T7 to T11 exit the intercostal spaces and run in the neurovascular plane between the internal oblique and the transversus abdominis muscles. The subcostal nerve (T12) and the ilioinguinal/iliohypogastric nerves (L1) also travel in the plane between the transversus abdominis and internal oblique, innervating both these muscles.
Caudal neuroaxial block plays a crucial role as a daily routine in pediatric anesthesia for the majority of operations (e.g. inguinal hernia repair, hydrocoele, orchidopexy, circumcision, orthopedic interventions on the lower limb, anorectal procedures) in addition to its role in specific types of abdominal and thoracic surgery.
The quadratus lumborum (QL) block was first described by Blanco. Currently, the QL block is performed as one of the perioperative pain management procedures for all generations (pediatrics, pregnant, and adult) undergoing abdominal surgery.
The aim of the work was to compare between ultrasound guided caudal block and quadratus Lamborum block (QL) for inguinal herniotomy in preschool children as regards postoperative pain score, duration of analgesia, total analgesic requirements, and the incidence of adverse events.
The study was carried out in Alexandria University Hospitals on 60 patients, aged 2 to 5 years, with American Society of Anesthesiologists (ASA) physical status scores of I and II, planned for inguinal herniotomy under general anesthesia. This study was a randomized prospective double blinded clinical trial. The sample size was calculated by Community Medicine Department Alexandria University. Informed consent was taken from the parents.