Vol. 7, Issue 2, Part A (2025)

Introduction: Intrathecal and caudal blocks regulate hemodynamics, reduce neuroendocrine responses, enhance recovery, improve pain relief, and minimize opioid side effects.

Objective: To evaluate the influence of intrathecal anesthesia on infants' stress responses and hemodynamics compared to caudal epidural anesthesia for laparoscopic inguinal herniorrhaphy.

Methods: This prospective randomized control study involved 120 patients aged from full term one month to year, both sexes, with laparoscopic inguinal herniorrhaphy, allocated into three groups. Control Group (C): General anesthesia (GA) group, intrathecal Group (I) and caudal block group (E).

Results: Groups I and E had significantly reduced sevoflurane consumption intraoperatively than Group C, and Group I had a lower consumption than Group E (p<0.001). Groups I and Group E had significantly lower total analgesic intake and rescue analgesia needs in comparison to Group C (p<0.001), while no substantial variation in Groups I and E had considerably lower FLACC scores immediately after surgery than Group C, and Group I had a lower score than Group E (p<0.001). Groups I and E exhibited significantly lower FLACC scores at 6, 12, and 24 hours than Group C (P <0.001).

Conclusions: Intrathecal anesthesia is effective and safe in providing intraoperative analgesia in infants undergoing laparoscopic inguinal herniorrhaphy with lower stress response in the form of decrease in serum glucose and serum cortisol level, intraoperative anesthetic consumption, total analgesics consumption, need for rescue analgesia post operative, pain score and better hemodynamics intra operative compared to caudal epidural anesthesia (CEA) and GA.