الفهرس 
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Abstract
Hypospadias repair is frequently associated with a considerable
postoperative pain. This pain increases analgesic consumption, disturbs bowel
function and prolongs the duration of hospital stay.
In pediatric care, due to the nature of the patient and depending on the
age group it is often difficult, or even impossible, to fully understand the
extent of pain perceived, leading to insufficient pain management.
Appropriate pain treatment aims to improve the results of the surgery,
reduce postoperative morbidity, and decrease the duration of hospital stay.
Treatment of postoperative pain after hypospadias repair based on
conventional drugs for pain relief (large doses of acetaminophen, NSAID, and
oral or intravenous opioid). This is associated with adverse effects, such as
nausea, sedation, hypotension and increased cardiac load. All these effects
delay rehabilitation and early discharge.
Here the role of the regional block e.g. erector spinae plane block (ESP
block) appears to overcome these side effects for the management of acute
postoperative pain in surgical interventions, Recently, ultrasound guided
technique regional block have been used successfully to avoid the problem of
the blind technique and provided better control of a variety of postoperative
pain after hypospadias repair.
This study was done to compare the postoperative analgesic effect of
sacral erector spinae plane block versus caudal epidural block in pediatric
patients undergoing hypospadias repair.
The present study was conducted on forty patients scheduled for
hypospadias surgeries under general anesthesia were enrolled in the study
divided randomly into two groups of 20 patients. The participant patients were
aged between 1 and 6 years with ASA I-II physical status.
group I: Epidural caudal block, (n=20) patients
group II: Bilateral Sacral erector spinae plane block, (n=20) patients.
All patients will be given Acetaminophen IV injection (15 mg/kg)
every 6 hours. If modified objective pain scale (MOPS) rose above 4, the
patient will be given IV Ketrolac 0.75 mg/kg. 15 minutes later, if still in pain
the patient will be given IV Meperidine 0.5 mg/kg.