Beyond the caudal: truncal blocks an alternative option for analgesia in pediatric surgical patients.

PURPOSE OF REVIEW To discuss and compare the more commonly used truncal blocks with neuraxial techniques in children undergoing a variety of thoracic, abdominal and urological procedures. RECENT FINDINGS Owing to the advent of ultrasonography and its increasing use in regional anesthesia, there has been a renewed interest in implementing these techniques in children for intraoperative and postoperative pain management. SUMMARY The use of regional anesthesia particularly with ultrasound guidance is an integral part of pain management during the intraoperative and postoperative period in children who undergo surgery. Its use is essential in improving patient pain control and overall satisfaction as well as decreasing hospital stay and reducing hospital admission after surgery. Truncal blocks serve as an excellent alternative to neuraxial blockade, in patients who have a contraindication to neuraxial blockade, patients undergoing a unilateral procedure and those in an outpatient ambulatory setting undergoing routine procedures, wherein the adverse effects of neuraxial blockade such as motor weakness, difficulty ambulating, urinary retention, increased nausea and vomiting, may delay same day discharge.