Journal of the Bahrain Medical Society

Year 2023, Volume 35, Issue 2, Pages 21-27

https://doi.org/10.26715/jbms.35_2_3

Original Article

Comparing Postoperative Analgesia of Caudal and Penile Blockade using Bupivacaine in Children Undergoing Hypospadias Repair

Mohamed Magdeldin M. Ahmed1*, Ahmed Murad Bella2

Author Affiliation

1Anaesthesia specialist, Omdurman teaching hospital, Omdurman, Sudan. Department of Anaesthesia and Intensive Care, Military Hospital, Royal Medical Services, BDF, Riffa, Kingdom of Bahrain

2Head of Anaesthesia department, King Fahad Specialist Hospital Buraidah, KSA.

*Corresponding author:

Dr. Mohamed Magdeldin M. Ahmed, Anaesthesia specialist, Omdurman teaching hospital, Omdurman, Sudan. Department of Anaesthesia and Intensive Care, Military Hospital, Royal Medical Services, BDF, Riffa, Kingdom of Bahrain; Email: mohamedmagdeldin3@gmail.com

Received date: December 12, 2022; Accepted date: February 19, 2023; Published date: June 30, 2023 

For tables and figures, please refer to PDF.


Abstract

Background & Objectives: Caudal epidural and dorsal nerve penile blockade are commonly used for analgesia during and after hypospadias repair in children. Comparative studies to recommend the most effective block are in dearth. This study aims to compare penile block versus caudal block with bupivacaine for hypospadias repair in children in terms of post-operative effectiveness, pain management, and complications.

Methodology: The study was conducted on 60 male children, aged 1-9 years, undergoing hypospadias surgery under general anesthesia. The subjects were randomly divided into two groups: (A: caudal block, n=30, and B: penile block, n=30). A postoperative pain assessment was conducted using FLACC scale until 24 hours post-surgery.

Results: The patients from the A and B groups were comparable in age, weight, and ASA classification. All patients in the 2 groups did not feel pain post-operatively throughout the first 6 hours. One patient (3.4%) from each of the A and B groups started to feel pain 6 hours, and 9 hours, respectively after surgery. Eight patients (26.7%) in group A and 6 patients (20%) in group B felt pain throughout 6 to 24 hours after surgery. Four patients from group A and 1 patient from group B developed nausea and vomiting during the first 24 hours post-surgery.

Conclusion: The penile blockade proved to be more effective in lowering postoperative pain scores, with fewer side effects, thereby decreasing the need for rescue analgesia.

Keywords: Caudal block, bupivacaine, Caudal epidural, hypospadias repair, penile block