The purpose of this randomized blinded prospective study is to compare the analgesic efficacy and duration of a Pudendal Nerve Block (PNB) to a Caudal Block (CB) for pediatric patients, ages 6 months to 2 years, undergoing hypospadias repair.
Hypospadias repair is one of the most common congenital malformations of the penis in the United States. It has an incidence of about 1 in 300 births. A combination of general anesthesia and a caudal block or general anesthesia combined with a pudendal nerve block are commonly used for hypospadias repair. In our institution, hypospadias repair is typically done in infants and children ages 6 months to age two. A comparison of the efficacy of pudendal block versus the caudal block has not been undertaken in this younger population.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
TRIPLE
Enrollment
60
1 cc per kg of 0.2% ropivicaine in the caudal space given before the start of surgery.
0.5 cc per kg of 0.2% ropivicaine. Half of the volume given as a right pudendal block and the remaining volume given on the left pudendal nerve block given prior to the start of surgery
Nemours/ duPont Hospital for Children
Wilmington, Delaware, United States
Opioid consumption
The child's care giver will document the times that a rescue opioid was given to relieve pain.
Time frame: up to 24 hours
Intraoperative block assessment
A heart rate increase above of 20 percent of baseline will be an indication of inadequate block that will be treated with a rescue opioid.
Time frame: up to 3 hours
Post operative pain
The FLACC scale scores greater than 6 will be an indication of inadequate pain relief needing a rescue dosages of opioid.
Time frame: up to 2 hours
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