Please select the eligibility criteria that correspond to the clinical trial below.
Title: Transversus Abdominis Plane Block Versus Caudal Epidural for Lower Abdominal Surgery in Children: A Double-Blinded Randomized Controlled Trial
Brief Summary: Transversus abdominis plane block (TAPB) has emerged as a safe and effective regional anesthesia technique for providing postoperative lower abdominal analgesia. Complications associated with TAPB are very rare and pose a lower overall risk to the patient receiving a TAPB versus a caudal block, which is considered the gold standard for pediatric lower abdominal regional anesthesia. Our study hypothesis was that TAPB would be equivalent to caudal block initially in providing postoperative pain control but would show improved pain relief beyond the anticipated caudal duration.


Options:
A: Inclusion Criteria:

* Any patient who is 3 to 12 years of age
* Any patient undergoing outpatient umbilical hernia repair
* Any patient capable of expressing pain using the Faces Pain Rating Scale
* Patient has provided assent (if age 10 or older)
* Parents/guardians have provided informed consent

Exclusion Criteria:

* Any patient classified as ASA III, IV, or V by the American Society of Anesthesiologists
* Any patient with a history of Complex Regional Pain Syndrome
* Any patient with a history of chronic analgesic use
* Any patient who has used an analgesic including opioids, acetaminophen, and/or NSAID's within 24 hours prior to surgery
* Wards of the state
* Any patient with an incarcerated umbilical hernia requiring emergent surgery
* Any patient who does not speak English or Spanish
* Any patient whose primary caregiver does not speak English or Spanish
* Any patient who cannot express pain using the Faces Pain Rating Scale due to a disability
* Any patient whose primary caregiver is unable to comply with home instructions due to a disability
* Any patient less than 3 years of age or greater than 12 years of age
* Any patient with renal insufficiency
* Any patient with a bleeding disorder
B: Inclusion Criteria:

* age 0-2 years
* Elective surgery planned for inguinal hernia, or testicle retention
* Written informed consent from parent received
* ASA I-III

Exclusion Criteria:

* Exstrasystolias, known cardiac problem, medication affecting rhytm, allergy to drugs used
C: Inclusion Criteria:

* ASA physical status I-II
* undergoing unilateral low abdominal surgery

Exclusion Criteria:

* history of allergic reactions to local anesthetics
* rash or infection at the injection site
* anatomical abnormality
* bleeding diatheses, coagulopathy, liver diseases
D: Inclusion Criteria:

* Patients aged 1 to 9 years old scheduled for intravesicular ureteral reimplantation surgery

Exclusion Criteria:

1. Coagulation status or anatomic variations precluded safe placement of either TAPB or caudal epidural,
2. there was a preexisting chronic pain disorder,
3. there was a history of constipation that persisted despite appropriate treatment and that may have impacted postoperative pain assessments,
4. additional procedures were planned via a separate incision at the time of the ureteral reimplantation, 5) there was a contraindication to receiving the medications described in the protocol.

Answer: D