الفهرس 
PUDENDAL NERVE BLOCK (PNB)Only 14 pages are availabe for public view
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Abstract
SUMMARY
P
enile surgeries as hypospadias, urethroplasty and circumcision are of the most frequently performed surgical procedures in the pediatric male population. Using optimal analgesic regimen provide safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery.
Regional anesthetic techniques are commonly used to facilitate pain control in pediatric surgical procedures. The most commonly used techniques in pediatrics are caudal block and PNB.
This study was to compare the effectiveness and safety of US guided PNB versus caudal block for postoperative analgesia in pediatric male patients undergoing penile surgeries.
The study was conducted on 40 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups, each group consisted of 20 patients.
After preoperative assessment and obtaining baseline vital data, all patients received general anesthesia followed by the block at the end of the operation.
group PNB:
Patients in this group received US guided PNB. Patients were put in lithotomy position. An assistant supported the patient’s knees to maintain the position to facilitate performing the block. Two separate injection points were marked at 3 and 9 O’clock, about 2 to 2.5 cm from the center of the anus. After aseptic preparation of the skin, ultrasound guided injection will be done.
group CB:
Patients were put in the lateral decubitus position. After aseptic preparation of the skin, a 2.5 cm 22-gauge needle was inserted at a right-angle position to the skin until it pierced the sacrococcygeal ligament; the needle was then redirected at about 25° before being advanced to a depth of about 2 to 3 mm into the sacral canal.
The two groups were adequately monitored and assessed intra- and post-operatively and they were compared regarding demographic data, intra and postoperative hemodynamics, postoperative pain control using OPS score in the 1st 24 hours postoperatively and complications of both anesthetic techniques.
The results of the study revealed that US guided PNB provided significantly prolonged postoperative analgesia and reduced the postoperative analgesic requirements as compared with caudal block in pediatric patients and also demonstrated that both analgesic techniques are safe.
CONCLUSION
F
rom our study we can conclude that US guided PNB provided significantly prolonged postoperative analgesia and reduced the postoperative analgesic requirements as compared with caudal block in pediatric patients undergoing penile surgeries and also demonstrated that both analgesic techniques are safe.