Comparison of Analgesic Efficacy of Sacral Erector Spinae Plane Block and Caudal Epidural Block in Pediatric Patients Undergoing Hypospadias Surgery

Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization

Status: Completed

Conditions: Hypospadias

Treatments: Procedure: Caudal Block Anesthesia; Procedure: Erector Spinae Plane Block

Study type: Observational

Funder types: Other

Identifiers

NCT07286786

CemilTasciogluDr.Kankal

Details and patient eligibility

About

The goal of this observational study is to learn about effects of block strategies (sacral erector spinae plane block - ESP, caudal block) on perioperative pain in pediatric patients undergoing hypospadias surgery. The main question it aims to answer is:

Is there a difference in analgesic efficacy between sacral erector spinae plane block and caudal block in pediatric patients undergoing hypospadias surgery? Eighty six pediatric patients (ages 1-7 years, ASA I-II) scheduled for hypospadias repair under general anesthesia were included in this prospective randomized study. Both blocks were performed using 0.25% bupivacaine, at doses of 0.5 mL/kg for our study. Pain was assessed using the FLACC scale at 1, 2, 4, 6, 12 and 24 hours postoperatively.

Full description

Postoperative pain management in pediatric urological surgery, particularly in hypospadias repair, is essential for reducing distress, minimizing analgesic requirements, and promoting early recovery. Caudal epidural block remains the gold standard for postoperative analgesia in this patient population due to its well-established safety and efficacy. However, its limitations-such as the risk of motor block, urinary retention, and unpredictable spread of local anesthetic-have encouraged the exploration of alternative regional techniques.

The sacral erector spinae plane (ESP) block, first described for thoracic and lumbar analgesia, has recently been applied in the sacral region as a novel approach for pediatric surgeries involving the perineum and genital area. The block is technically simpler, avoids the epidural space, and carries a low risk of complications. Nevertheless, data comparing its efficacy with the traditional caudal block in hypospadias surgery remain limited.

This study aimed to compare the analgesic efficacy and safety of sacral ESP block and caudal epidural block in children undergoing hypospadias repair surgery.

Enrollment: 86 patients

Sex: All

Ages: 1 to 7 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Children aged 1-7 years
• Classified as ASA physical status I-II
• Scheduled for primary hypospadias repair were enrolled

Exclusion criteria

• Infection at the injection site
• Coagulopathy
• Spinal anomalies
• Allergy to local anesthetics
• Parental refusal.

Trial design

86 participants in 2 patient groups

Group C (caudal block)

Description:

Group

Treatment:

Procedure: Caudal Block Anesthesia

Group S (sacral ESP block)

Description:

Cohort

Treatment:

Procedure: Erector Spinae Plane Block