Introduction: Caudal block (CB) and erector spina plane block (ESPB) have been shown to provide effective postoperative analgesia following circumcision. Our aim was to compare the analgesic efficacy of sacral ESPB and CB, as well as the time to first analgesic requirement and postoperative complications. Methods: Patients aged 1–7 years in the ASA I-II group, who were scheduled for circumcision, were included in the study. Blocks were performed under general anesthesia before the operation. Postoperative pain was evaluated using the Face, Legs, Activity, Cry, and Consolability (FLACC) scores. Analgesic requirements in the first 24 h postsurgery, the time of first analgesia requirement, and postoperative complications were recorded. Results: A total number of 150 patients were included in the study. In the CB group, urinary retention was observed. No side effects were observed in the sacral ESPB group. The 4th and 6th h postoperative FLACC scores were lower in the ESP group. The number of analgesic consumption in the first 24 h postsurgery was significantly lower in the ESPB group (p < 0.001). Conclusion: Based on our results, sacral ESPB performed with ultrasonography is a simple and safe regional anesthesia method that can be used to provide effective postoperative analgesia for circumcision.

1.
Ozen
V
,
Yigit
D
.
A comparison of the postoperative analgesic effectiveness of low dose caudal epidural block and US-guided dorsal penile nerve block with in-plane technique in circumcision
.
J Pediatr Urol
.
2020
;
16
(
1
):
99
106
.
2.
Wiegele
M
,
Marhofer
P
,
Lönnqvist
PA
.
Caudal epidural blocks in paediatric patients: a review and practical considerations
.
Br J Anaesth
.
2019
;
122
(
4
):
509
17
.
3.
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
438.e8
.
4.
Sato
M
.
Ultrasound-Guided quadratus lumborum block compared to caudal ropivacaine/morphine in children undergoing surgery for vesicoureteric reflex
.
Paediatr Anaesth
.
2019
;
29
(
7
):
738
43
.
5.
Aksu
C
,
Gurkan
Y
.
Defining the indications and levels of erector spinae plane block in pediatric patients: a retrospective study of our current experience
.
Cureus
.
2019
;
11
(
8
):
e5348
.
6.
Aksu
C
,
Şen
MC
,
Akay
MA
,
Baydemir
C
,
Gürkan
Y
.
Erector spinae plane block vs quadratus lumborum block for pediatric lower abdominal surgery: a double blinded, prospective, and randomized trial
.
J Clin Anesth
.
2019
;
57
:
24
8
.
7.
Kendigelen
P
,
Tutuncu
AC
,
Emre
S
,
Altindas
F
,
Kaya
G
.
Pudendal versus caudal block in children undergoing hypospadias surgery: a randomized controlled trial
.
Reg Anesth Pain Med
.
2016
;
41
(
5
):
610
5
.
8.
Asgari
SA
,
Mansour Ghanaie
MM
,
Simforoosh
N
,
Kajbafzadeh
A
,
Zare’
A
.
Acute urinary retention in children
.
Urol J
.
2005
;
2
(
1
):
23
7
.
9.
Jareño-Collado
R
,
Sánchez-Sánchez
MM
,
Fraile-Gamo
MP
,
García-Crespo
N
,
Barba-Aragón
S
,
Bermejo-García
H
, et al
.
Ecchymosis and/or haematoma formation after prophylactic administration of subcutaneous enoxaparin in the abdomen or arm of the critically ill patient
.
Enferm Intensiva Engl Educ
.
2018
;
29
(
1
):
4
13
.
10.
Öksüz
G
,
Arslan
M
,
Bilal
B
,
Gişi
G
,
Yavuz
C
.
Ultrasound guided sacral erector spinae block for postoperative analgesia in pediatric anoplasty surgeries
.
J Clin Anesth
.
2020
;
60
:
88
.
11.
Desai
N
,
Chan
E
,
El-Boghdadly
K
,
Albrecht
E
.
Caudal analgesia versus abdominal wall blocks for pediatric genitourinary surgery: systematic review and meta-analysis
.
Reg Anesth Pain Med
.
2020
;
45
(
11
):
924
33
.
12.
Aksu
C
,
Cesur
S
,
Alparslan
V
,
Kuş
A
.
Is it time to replace caudal block: above or below the bone
.
J Clin Anesth
.
2020
;
61
:
109676
.
13.
Holland
EL
,
Bosenberg
AT
.
Early experience with erector spinae plane blocks in children
.
Paediatr Anaesth
.
2020
;
30
(
2
):
96
107
.
14.
Govender
S
,
Mohr
D
,
Bosenberg
A
,
Van Schoor
ANV
.
The anatomical features of an ultrasound-guided erector spinae fascial plane block in a cadaveric neonatal sample
.
Paediatr Anaesth
.
2020
;
30
(
11
):
1216
23
.
15.
İpek
CB
,
Kara
D
,
Yılmaz
S
,
Yeşiltaş
S
,
Esen
A
,
Dooply
SSSL
, et al
.
Comparison of ultrasound-guided transversus abdominis plane block, quadratus lumborum block, and caudal epidural block for perioperative analgesia in pediatric lower abdominal surgery
.
Turk J Med Sci
.
2019
;
49
(
5
):
1395
402
.
16.
Suresh
S
,
Long
J
,
Birmingham
PK
,
De Oliveira
GS
.
Are caudal blocks for pain control safe in children? an analysis of 18,650 caudal blocks from the pediatric regional anesthesia network (PRAN) database
.
Anesth Analg
.
2015
;
120
(
1
):
151
6
.
17.
Ahiskalioglu
A
,
Yayik
AM
,
Ahiskalioglu
EO
,
Ekinci
M
,
Gölboyu
BE
,
Celik
EC
, et al
.
Ultrasound-guided versus conventional injection for caudal block in children: a prospective randomized clinical study
.
J Clin Anesth
.
2018
;
44
:
91
6
.
18.
Karaca
O
,
Pinar
HU
,
Gokmen
Z
,
Dogan
R
.
Ultrasound-guided versus conventional caudal block in children: a prospective randomized study
.
Eur J Pediatr Surg
.
2019
;
29
(
6
):
533
8
.
You do not currently have access to this content.