Ultrasound-guided PNB and DPNB for Pediatric Distal Hypospadias Surgery

Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization

Status: Completed

Conditions: Hypospadias; Regional Anesthesia

Treatments: Procedure: Dorsal penile nerve block group; Procedure: Pudendal nerve block group

Study type: Observational

Funder types: Other

Identifiers

NCT04668183

1457

Details and patient eligibility

About

Hypospadias repair is a urological surgical operation that is very painful in the postoperative period and requires long-term analgesia. A dorsal penial nerve block (DPNB) and pudendal nerve block (PNB), which are regional anesthesia techniques for this operation, are used to provide postoperative analgesia.

Full description

The regional anesthesia techniques used for postoperative analgesia in hypospadias repair include the peripheral nerve blocks of pudendal nerve block (PNB) and dorsal penile nerve block (DPNB). Ultrasound (US) has recently become increasingly popular in regional anesthesia practice and is used to aid these two peripheral nerve block applications in various pediatric urological procedures. US-guided DPNB has been shown to provide effective and long-term analgesia when compared to caudal epidural block in a recent study on hypospadias surgery in the pediatric population.

Enrollment: 30 patients

Sex: Male

Ages: 1 to 7 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Male patients aged between 1-7 years
• American Society of Anesthesiologists (ASA) I-II group
• Distal hypospadias surgery
• Able to communicate in Turkish
• Willing to participate to the study (parents and children)

Exclusion criteria

• Less than 1 or more than 7 years of age
• A neurological deficit, bleeding diathesis, or a history of local anesthetic allergy; an infection or redness in the injection area, congenital low back anomaly, liver disorder, a psychiatric disorder, mental retardation, or communication problems detected during examination
• Unwilling to to participate to the study ((parents or children)

Trial design

30 participants in 2 patient groups

Pudendal Nerve Block

Description:

Linear ultrasound probe and the sacral hiatus at the sacral cornu level was visualized using an out-of-plane transverse view at 5-10 megahertz . The linear probe was then rotated 90 degrees and placed longitudinally in the midline to evaluate the sacral cornus, sacrococcygeal ligament and sacral bone.

Treatment:

Procedure: Pudendal nerve block group

Dorsal Penile Nerve Block

Description:

Ultrasound (US) guided dorsal penile nerve block with in plane technique was done. Half of the total 0.2 ml/kg dose of 0.25% bupivacaine was administered while observing its distribution with US. The same procedure was then repeated on the other side of the penis.

Treatment:

Procedure: Dorsal penile nerve block group