الفهرس | Only 14 pages are availabe for public view |
Abstract Hypospadias repair is a painful intervention that is frequently performed in pediatric patients. It is generally performed under general anesthesia in order to eliminate fear and anxiety. Using optimal analgesic regimen provide safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Many regional anesthesia techniques including the caudal epidural block, the classical dorsal penile nerve block (landmarkbased) have been used for hypospadias repair surgeries to minimize pain and complications. In this study, the aim is to compare postoperative analgesia between caudal block and penile block with bupivacaine in elective hypospadias repair cases. The study was conducted on 60 randomly chosen children in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups, each group consisted of 30 patients group C and group P. Summary 64 After preoperative assessment and obtaining baseline vital data, all patients received general anesthesia. Patients in group C received caudal block (0.5ml/kg) of 0.25% bupivacaine. Patients in group P received penile block (0.5ml/kg) of 0.25% bupivacaine. This current study revealed also that there was no statistical significant difference between two groups regarding hemodynamics including Systolic and diastolic blood pressure (P>0.05) and HR (P>0.05). Postoperative pain was evaluated by FLACC pain score at PACU, 2, 4 and 8, 12, 16 and 24 hrs. There was a significant increase in the pain score in group C starting from the fourth hour postoperativly and thereafter every hour, while the lowest pain scores were recorded in group P (P<0.05). Also, the time to first need for rescue analgesia was significantly shorter in group C (240 +/-105 min) compared with group P (720 +/-301) (P > 0.01).The total rescue analgesic requirement was significantly lower in group P (168.26 +/-22.69) than group C (573.8+/- 124.1) (P < 0.01).Postoperative time of ambulation was significantly lower in group C (6.95+/- 3.22) compared with group P (5.28+/- 1.99) (P < 0.01). |