Review Article

A Systematic Review and Meta-Analysis of Caudal Block as Compared to Noncaudal Regional Techniques for Inguinal Surgeries in Children

Table 1

Summary of pooled outcomes in subgroups.

GroupNumber of studies and childrenOutcomeRemarks

Outcome: early rescue analgesia (up to 4 hrs)
CB versus INB4 studies: CB: 122
INB: 106
RR: 0.80 [0.62, 1.04]
No significant difference
CB versus INF4 studies: CB: 104
INF: 102
RR: 0.94 [0.65, 1.36]
No significant difference
CB versus combined5 studies: CB: 173
Combined: 182
RR: 0.59 [0.32, 1.07]
No significant difference

Outcome: late rescue analgesia (4–24 hrs)
CB versus INB2 studies: CB = 44, INB = 50RR: 0.97 [0.50, 1.87]
No significant difference
CB versus INF4 studies
CB = 100, INF = 106
RR: 1.05 [0.74, 1.51]
No significant difference
CB versus combined2 studies
CB = 112 and combined = 120
RR: 0.74 [0.60, 0.90], 

ARR = 17.4%
Significantly favouring caudal

Outcome: motor block
CB versus INB3 studies: CB = 109, INB = 87RR: 2.17 [1.01, 4.64] 

Motor block more common with CB
ARR = 7.2%
CB versus INF1 study: CB = 22, INF = 27Event rate: 3/22 (CB)
0/27 (INF)
Only 1 study; motor block not observed with INF
CB versus combined2 studies: CB = 108 and combined = 116RR: 5.62 [0.67, 46.98]
All 5 patients noted to have a motor block belonged to CB

Outcome: vausea-vomiting
CB versus INB2 studies: CB = 50, INB = 49RR: 0.57 [0.18, 1.80]
No significant difference
CB versus INF2 studies: CB = 49, INF = 54RR: 0.77 [0.36, 1.64]
No significant difference
CB versus combined3 studies: CB = 146 and combined = 154RR: 1.13 [0.86, 1.50]
No significant difference

Outcome: urinary retention
CB versus INB2 studies: CB = 74, NB = 52RR: 2.09 [0.96, 4.53] 
I2 = 0, favouring INB, but not significant
CB versus INF2 studies: CB = 49
INF = 54
RR: 2.59 [1.10, 6.12], 
: ARR = 19.3%
Significantly favouring INF
CB versus combined1 study: CB = 96, combined = 104Event rate: 1/96 (CB)
1/104 (combined)
Only 1 study