Comparative study between ultrasound guided pudendal nerve block versus caudal epidural block anesthesia in children undergoing hypospadias Surgery

Abstract

Hypospadias surgery is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provide safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Regional anesthetic techniques are commonly used to facilitate pain control in pediatric surgical procedures. The most commonly used techniques in pediatrics are caudal block and PNB. This study was to compare the effectiveness and safety of US guided PNB versus caudal block as a part of multimodal analgesia in pediatric patients undergoing hypospadias surgery. The study was conducted on 50 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups, each group consisted of 25 patients. After preoperative assessment and obtaining baseline vital data, all patients received general anesthesia. Group A: Patients in this group received US guided PNB on the same side of surgery. Patients were put in lithotomy position. An assistant supported the patient’s knees to maintain the position to facilitate performing the block. Two separate injection points were marked at 3 and 9 o’clock, about 2 to 2.5 cm from the center of the anus. After aseptic preparation of the skin, ultrasound guided injection will be done.