Caudal block versus penile block for postoperative analgesia in children undergoing hypospadias repair

Abstract

Abstract Background Hypospadias repair is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provides safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Aim of the Work The aim of this work is to evaluate the success rate and the effectiveness of penile block for hypospadias repair in pediatric patients in comparison with caudal block. Patients and Methods This prospective randomized study was conducted in Ain Shams University Hospitals; Pediatric Surgery Unit. It included 80 ASA I or II patients undergoing hypospadias (distal penile and mid penile) repair. They were divided into two groups: Group P: Group P penile block (n = 40) received dorsal penile nerve block by using the subpubic approach technique. Group C: Group C caudal block (n = 40) received caudal epidural block using a 22-G needle in the lateral decubitus position. Results There was no statistically significant difference between two groups regarding haemodynamics including MBP (P < 0.05) and HR (P < 0.05). FLACC pain scores were significantly lower in group C compared with group P (P< 0.01). Also, the time to first need for analgesia was significantly lower in group C compared with group P (P< 0.001) .The total rescue analgesic requirement was also significantly lower (P< 0.001) in group C compared with group P.Postoperative time of ambulation was also significantly lower (P< 0.05) in group P compared with group C. Conclusion the current study revealed that caudal block provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and prolonged time of ambulation as compared with penile block in pediatric patients undergoing hypospadias repair.