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Abstract
Caudal analgesia is commonly used for perioperative pain control in pediatric abdominal surgeries. The aim of this study was to compare preemptive intravenous multimodal analgesia supplemented with local anesthetic infiltration (LAI) versus preemptive caudal analgesia with bupivacaine and morphine, regarding intraoperative analgesia, stress response, postoperative pain and adverse effects in pediatric patients undergoing abdominal surgery for excision of suprarenal neuroblastoma. Intravenous multimodal analgesia supplemented with LAI improves analgesia in PACU and reduces morphine consumption within the first 24 h postoperatively more than single dose caudal analgesia in pediatric abdominal surgeries and both techniques can attenuate the intraoperative endocrine response to surgery