Introduction: The primary aim of the study was to use the duration until the first postoperative analgesic requirement after two different block techniques to compare the analgesic effect. The secondary aims were to compare the two methods for postoperative Children’s Hospital Eastern Ontario Pain Scale (CHEOPS) scores, complications, and parental satisfaction level. Materials and Methods: This prospective, observational study was conducted with male patients aged 1–7 years in the ASA I–II group, who were scheduled for hypospadias surgery between November 2019 and April 2020. Ultrasound (US)-guided pudendal nerve block (PNB) or US-guided dorsal penile nerve block (DPNB) was administered under general anesthesia before the operation. Postoperative analgesic need, postoperative pain, complications, and parental satisfaction were noted. The STROBE checklist was followed for reporting. Results: The study was conducted with 30 patients in total, divided into 15 patients receiving PNB and 15 patients receiving DPNB. The effective minimum block duration was longer in the pudendal group at 22.22 ± 0.61 h than in the DPNB group at 22.19 ± 0.57 h. Additional analgesic was required in 4 subjects in the pudendal group and 5 in the DPNB group. There was no statistically significant difference in terms of the variables between the two groups (p > 0.05). Discussion: US-guided DPNB and PNB were shown to provide successful postoperative analgesia and to have similar effectiveness in pediatric patients undergoing hypospadias surgery in this first prospective study of its kind in the literature. Conclusions: US-guided DPNB and PNB have been demonstrated to provide effective, safe, and long-term postoperative analgesia in pediatric patients who have undergone hypospadias surgery. Parental satisfaction in both groups is positively influenced by the minimum postoperative analgesia requirement, the long-term analgesic effect, and the lack of any complications.

1.
Aksu
C
,
Akay
MA
,
Şen
MC
,
Gürkan
Y
.
Ultrasound-guided dorsal penile nerve block vs neurostimulator-guided pudendal nerve block in children undergoing hypospadias surgery: a prospective, randomized, double-blinded trial
.
Paediatr Anaesth
.
2019
;
29
(
10
):
1046
52
.
2.
Ozen
V
,
Yigit
D
.
Caudal epidural block versus ultrasound-guided dorsal penile nerve block for pediatric distal hypospadias surgery: a prospective, observational study
.
J Pediatr Urol
.
2020
;
16
(
4
):
438.e1
8
.
3.
Almusafer
M
,
Abduljabbar
OH
,
Buchholz
N
.
Stented versus non-stented snodgrass urethroplasty for distal hypospadia repair
.
Urol Int
.
2020
;
104
(
1–2
):
156
9
.
4.
Kundra
P
,
Yuvaraj
K
,
Agrawal
K
,
Krishnappa
S
,
Kumar
LT
.
Surgical outcome in children undergoing hypospadias repair under caudal epidural vs penile block
.
Paediatr Anaesth
.
2012
;
22
(
7
):
707
12
.
5.
Alizadeh
F
,
Heydari
SM
,
Nejadgashti
R
.
Effectiveness of caudal epidural block on intraoperative blood loss during hypospadias repair: a randomized clinical trial
.
J Pediatr Urol
.
2018
;
14
(
5
):
420.e1
5
.
6.
Karakaya
AE
,
Doğan
AB
,
Güler
AG
.
Use of a stent in distal hypospadias repaired by tubularized incised plate urethroplasty: a comparative study
.
Urol Int
.
2019
;
102
(
3
):
336
40
.
7.
Kendigelen
P
,
TutuncuEmre
ACS
,
Altindas
F
,
Kaya
G
.
Pudendal versus caudal block in children undergoing hypospadias surgery: a randomized controlled study
.
Reg Anesth Pain Med
.
2016
;
41
(
5
):
610
5
.
8.
Metzelder
ML
,
Kuebler
JF
,
Glueer
S
,
Suempelmann
R
,
Ure
BM
,
Petersen
C
.
Penile block is associated with less urinary retention than caudal anesthesia in distal hypospadia repair in children
.
World J Urol
.
2010
;
28
(
1
):
87
91
.
9.
Saavedra-Belaunde
JA
,
Soto-Aviles
O
,
Jorge
J
,
Escudero
K
,
Vazquez-Cruz
M
,
Perez-Brayfield
M
.
Can regional anesthesia have an effect on surgical outcomes in patients undergoing distal hypospadia surgery
.
J Pediatr Urol
.
2017
;
13
(
1
):
45.e1
4
.
10.
Ozen
V
,
Yigit
D
.
A comparison of the postoperative analgesic effectiveness of ultrasound-guided dorsal penile nerve block and ultrasound-guided pudendal nerve block in circumcision
.
Urol Int
.
2020
;
104
:
871
7
.
11.
Hecht
S
,
Piñeda
J
,
Bayne
A
.
Ultrasound-guided pudendal block is a viable alternative to caudal block for hypospadias surgery: a single-surgeon pilot study
.
Urology
.
2018
;
113
:
192
6
.
12.
McGrath
PJ
,
Walco
GA
,
Turk
DC
,
Dworkin
RH
,
Brown
MT
,
Davidson
K
,
.
Core outcome domains and measures for pediatric acute and chronic/recurrent pain clinical trials: PedIMMPACT recommendations
.
J Pain
.
2008
;
9
(
9
):
771
83
.
13.
Walco
GA
,
Kopecky
EA
,
Weisman
SJ
,
Stinson
J
,
Stevens
B
,
Desjardins
PJ
,
.
Clinical trial designs and models for analgesic medications for acute pain in neonates, infants, toddlers, children, and adolescents: ACTTION recommendations
.
Pain
.
2018
;
159
(
2
):
193
205
.
14.
McGrath
PA
,
Johnson
G
,
Goodman
JT
,
Mcgrath
PJ
,
Johnson
G
,
Schillinger
J
,
.
CHEOPS: a behavioral scale for rating postoperative pain in children
. In:
Fields
HL
,
Dubner
R
,
Cervero
F
, editors.
Advances in pain research and therapy
.
New York
:
Raven Press
;
1985
. p.
395
402
.
15.
von Baeyer
CL
,
Spagrud
LJ
.
Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years
.
Pain
.
2007
;
127
(
1–2
):
140
50
.
16.
Soh
CR
,
Ng
SB
,
Lim
SL
.
Dorsal penile nerve block
.
Paediatr Anaesth
.
2003
;
13
(
4
):
329
33
.
17.
Visoiu
M
,
Pan
S
.
Quadratus lumborum blocks: two cases of associated hematoma
.
Paediatr Anaesth
.
2019
;
29
(
3
):
286
8
.
18.
Gaudet-Ferrand
I
,
De La Arena
P
,
Bringuier
S
,
Raux
O
,
Hertz
L
,
Kalfa
N
,
.
Ultrasound-guided pudendal nerve block in children: a new technique of ultrasound-guided transperineal approach
.
Paediatr Anaesth
.
2018
;
28
(
1
):
53
8
.
You do not currently have access to this content.