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This prospective observational study aims to investigate the relationship between anatomical parameters-specifically the distance from the anus to the needle insertion point and the depth required to reach the pudendal nerve-during neurostimulation-guided pudendal nerve block and patients' age, height, and weight in children undergoing penile surgery.
The pudendal nerve originates from the sacral nerve roots Sacral2-Sacral4 and provides sensory and motor innervation to the penile and perineal regions. Effective postoperative analgesia is essential in pediatric penile surgeries. Pudendal nerve block may provide longer-lasting and more effective analgesia compared to caudal or penile blocks.
However, due to age- and size-related anatomical variability in children, data regarding optimal needle insertion distance and depth to reach the pudendal nerve are limited. In this study, neurostimulation will be used to confirm pudendal nerve localization, and anatomical measurements will be analyzed in relation to demographic parameters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pediatric Penile Surgery Cohort | Children aged 1-18 years undergoing penile surgery with neurostimulation-guided pudendal nerve block; anatomical measurements of needle insertion distance from anus and nerve depth are recorded. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Neurostimulation-Guided Pudendal Nerve Block | Procedure | Bilateral pudendal nerve block is performed under general anesthesia with neurostimulation guidance. Anatomical measurements, including distance from anus to needle insertion point and nerve depth, are recorded for each patient. Bupivacaine 0.25% is used at 0.25 ml/kg per side, with a maximum total dose of 2 mg/kg. |
| Measure | Description | Time Frame |
|---|---|---|
| Horizontal distance from anus to needle insertion point and Depth from skin surface to pudendal nerve | The horizontal distance from the anus to the needle insertion point is measured in centimeters for each patient using neurostimulation-guided pudendal nerve block. Measurements are recorded separately for the right and left sides.The depth from the skin surface to the pudendal nerve is measured in centimeters using neurostimulation guidance. Measurements are recorded separately for the right and left sides. The relationship of this distance and the association of nerve depth with patient age, height, and weight will be analyzed. | During pudendal nerve block procedure |
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Inclusion Criteria:
Exclusion Criteria:
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This study includes children aged 1-18 years who are undergoing penile surgery. Neurostimulation-guided pudendal nerve block will be performed, and anatomical measurements, including the horizontal distance from the anus to the needle insertion point and the depth from the skin to the pudendal nerve, will be recorded. Measurements will be taken separately for the right and left sides. Patient age, height, and weight will also be recorded, and their relationship with the anatomical measurements will be analyzed. The study will be conducted at Istanbul University-Cerrahpasa, Department of Pediatric Surgery.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Munevver Kayhan, Lecturer Doctor | Contact | 02124143000 | munevver.kayhan@iuc.edu.tr | |
| Pinar Kendigelen, Professor Doctor | Contact | 02124143000 | pinarken@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Munevver Kayhan, Lecturer Doctor | Istanbul University-Cerrahpasa, Cerrahpasa Medicine of Faculty | Principal Investigator |
| Pinar Kendigelen | Istanbul University-Cerrahpasa, Cerrahpasa Medicine of Faculty | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul University-Cerrahpasa, Cerrahpasa Medicine of Faculty | Bakırköy | Istanbul | 34153 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27501015 | Result | Kendigelen P, Tutuncu AC, Emre S, Altindas F, Kaya G. Pudendal Versus Caudal Block in Children Undergoing Hypospadias Surgery: A Randomized Controlled Trial. Reg Anesth Pain Med. 2016 Sep-Oct;41(5):610-5. doi: 10.1097/AAP.0000000000000447. | |
| 30074928 | Result | Walker BJ, Long JB, Sathyamoorthy M, Birstler J, Wolf C, Bosenberg AT, Flack SH, Krane EJ, Sethna NF, Suresh S, Taenzer AH, Polaner DM, Martin L, Anderson C, Sunder R, Adams T, Martin L, Pankovich M, Sawardekar A, Birmingham P, Marcelino R, Ramarmurthi RJ, Szmuk P, Ungar GK, Lozano S, Boretsky K, Jain R, Matuszczak M, Petersen TR, Dillow J, Power R, Nguyen K, Lee BH, Chan L, Pineda J, Hutchins J, Mendoza K, Spisak K, Shah A, DelPizzo K, Dong N, Yalamanchili V, Venable C, Williams CA, Chaudahari R, Ohkawa S, Usljebrka H, Bhalla T, Vanzillotta PP, Apiliogullari S, Franklin AD, Ando A, Pestieau SR, Wright C, Rosenbloom J, Anderson T; Pediatric Regional Anesthesia Network Investigators. Complications in Pediatric Regional Anesthesia: An Analysis of More than 100,000 Blocks from the Pediatric Regional Anesthesia Network. Anesthesiology. 2018 Oct;129(4):721-732. doi: 10.1097/ALN.0000000000002372. |
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| Ayse Cigdem Tutuncu, Professor Doctor | Istanbul University-Cerrahpasa, Cerrahpasa Medicine of Faculty | Study Chair |