title: Pudendal Versus Caudal Block in Children Undergoing Hypospadias Surgery: A Randomized Controlled Trial.
abstract: OBJECTIVE
  Postoperative pain management after hypospadias surgery is often challenging. Caudal block is used for analgesia but has limitations. This study compares the analgesic efficiency of pudendal block with that of caudal block in pediatric patients undergoing hypospadias repair surgery.
  
  
  METHODS
  This prospective, double-blind, randomized, controlled study enrolled 84 patients receiving pudendal block or caudal block before hypospadias surgery. In the pudendal group, the pudendal nerve was identified using a nerve stimulator, and the block consisted of 0.25% bupivacaine 0.5 mL/kg. In the caudal group, the caudal block used 0.2% bupivacaine 1 mL/kg. Our primary outcome was pain intensity within 24 hours postoperatively. The trial was registered at ClinicalTrials.gov (number: NCT02390388).
  
  
  RESULTS
  For the primary outcome, patients in the pudendal group had lower postoperative pain intensity when compared with the caudal group (P < 0.001). Three patients in the pudendal group and all of the patients in the caudal group needed additional analgesia within 24 hours after the surgery (P < 0.001). The family satisfaction rate was significantly higher in the pudendal group (P < 0.001).
  
  
  CONCLUSIONS
  For the pudendal group, the pain scores for the first 24 hours after the surgery were significantly lower and the duration of analgesia was longer.
authors: From the Departments of *Anesthesiology and Intensive Care, and †Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors: Pinar
authors: P
authors: Kendigelen
authors: Ayse Cigdem
authors: AC
authors: Tutuncu
authors: Senol
authors: S
authors: Emre
authors: Fatis
authors: F
authors: Altindas
authors: Guner
authors: G
authors: Kaya
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D006801:Humans; D007021:Hypospadias / Q000175:diagnosis / Q000601:surgery*; D007223:Infant; D008297:Male; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D060525:Pudendal Nerve; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects*
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine