Sacral Erector Spinae Plane Block Versus Caudal Block in Penile Surgeries in Pediatrics

The Efficacy of Post-operative Analgesia of Sacral Erector Spinae Plane Block Versus Caudal Block in Penile Surgeries in Pediatrics

The study will be conducted to compare the efficacy of ultrasound guided Sacral Erector Spinae Plane Block to caudal block on pain management in penile surgeries in pediatrics.

The erector spinae plane block (ESPB) is a relatively new interfacial plane block that is used for postoperative analgesia in penile surgeries in pediatrics.

The sacral ESPB is a technique known to block the posterior branches of the sacral nerves. Also it blocks the lumbosacral plexus especially the sacral spinal nerves (S2_S4) when applied to high levels.

Caudal epidural block in children is one of the most widely administrated technique of regional anesthesia; it is an efficient way to offer perioperative analgesia for painful sub umbilical interventions. It enables early ambulation, hemodynamic stability and spontaneous breathing in patient groups at maximum risk of difficult airway.

Caudal block is a known worldwide technique but with some risks such as subdural, intra vascular injection, infection, injury to the nerve root or local anesthesia. Therefore, we try a new technique as sacral ESPB.

Inclusion Criteria:

• Children aged between 3 to 6 years.
• Male children.
• American Society of Anesthesiologists (ASA) I - II.
• Male who admitted for penile surgeries.

Exclusion Criteria:

• Parents who refused regional anesthesia.
• Patients presented with symptoms or signs of increased intracranial tension.
• Patients presented with advanced kidney, cardiac or liver diseases.
• Coagulation and bleeding disorders.
• Patients presented with skin or soft tissue infection at the proposed site of needle Insertion.
• Pre-existing neurologic disease (e.g. lower extremity peripheral neuropathy).
• Patients with known allergy to study drugs.
• Patints with developmental or mental delay.