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

Abstract

ABSTRACT Background: Caudal block is recommended for analgesia during and after hypospadias repair operation of the penis in children. Aim of the Study: Compare the effectiveness of caudal block vs. dorsal penile block in children undergoing hypospadias repair surgery with respect to postoperative analgesia and appeal for rescue analgesics during the first 24hours. ‎ Patients and Methods: ‎ The study was conducted on 40 male children, ASA I-II, 4-8 years of age undergoing hypospadias repair surgery under general anesthesia. Children were randomly classified into two groups: (Group P) (penile group=20 patients) received a penile block of 2mL bupivacaine 0.25 per cent on each side, (Group C) (caudal block group=20 patients) with a caudal block of 0.25 per cent (1mg / kg) bupivacaine on each side. Postoperative pain assessment will be conducted by mCHEOPS) Children's Hospital of Eastern Ontario Pain Scale (request for rescue analgesic and complete analgesic dosage (mg.). Results: The PACU mCHEOPS pain score was lower in Group C at 2 hrs, 4 hrs and 6 hrs postoperative. Also, the time for the first need for rescue analgesia was statistically significantly lower in group C. The overall analgesic rescue requirement in Group C was also significantly lower. Conclusions: Caudal block tended to be more effective in lowering postoperative pain scores and decreasing the need for rescue analgesia. Key Words: Caudal block, Penile block, Bupivacaine, Hypospadias repair.