Comparison of analgesic efficacy of sacral erector spinae plane block and caudal block in pediatric patients undergoing hypospadias repair surgery

Background

Hypospadias is one of the most common congenital anomalies observed in childhood and treated surgically. This study was designed to compare the postoperative analgesic efficacy of caudal block with sacral ESP block in children following hypospadias surgery.

Methods

This study was designed as a single-center, prospective, randomized, controlled, double-blinded study. A total of 68 male patients were included in the study, and they were divided into two groups: one with sacral ESP (Group ESP) and the other with caudal block (Group C), each group consisting of 34 patients. FLACC (Face, Legs, Activity, Cry, Consolability) scores of all patients were observed and recorded during the first 24 h postoperatively. FLACC scores were recorded at 5 min, 30 min, and 1, 2, 4, 6, 12, and 24 h postoperatively.

Results

The duration of analgesia in Group C (9.7 ± 2.8 h) was statistically significantly longer than in Group ESP (6.3 ± 1.6 h) (p < 0.001). FLACC scores in Group C (2.2 ± 0.5, 2.6 ± 0.6, 3.5 ± 1.5) were statistically significantly lower at 4 and 6 h and statistically significantly higher at 12 h postoperatively than those of Group ESP (2.7 ± 0.7, 4.1 ± 2, 2.7 ± 0.9) (p < 0.001). Group ESP (2.2 ± 0.4) mean FLACC value was found to be statistically significantly higher than that of Group C (1.9 ± 0.3) (p = 0.001). Patient relatives' satisfaction rate in Group C was statistically significantly higher than in Group ESP (p = 0.001).

Conclusion

In the present study, we found that caudal block resulted in a longer duration of postoperative analgesia and lower FLACC scores than ESP block in pediatric patients who underwent hypospadias surgery.