Analgesia for Perineal Surgeries in High-risk Pediatric Patients

Efficacy of Ultrasound-guided Sacral Multifidus Plane Block as Perioperative Analgesia for Anal and Penile Surgeries in High-risk Pediatric Patients

Perioperative pain management in pediatric patients, especially for anorectal and penile surgeries, presents significant challenges for anesthetists. Complications associated with systemic analgesia, such as respiratory issues, cardiovascular problems, and neurological effects, can be avoided by using regional anesthesia. This study aims to evaluate the effectiveness of Ultrasound-Guided Sacral Multifidus Plane Block as a method for perioperative analgesia in high-risk pediatric patients undergoing anorectal and penile surgeries, to reduce the risks associated with systemic analgesia.

Effective postoperative pain control in pediatric patients remains a major concern, particularly in those undergoing anal, perineal and penile surgeries. Inadequate analgesia is associated with delayed recovery, increased stress response, prolonged hospitalisation, and higher postoperative morbidity. This study aims to evaluate the efficacy of ultrasound-guided sacral multifidus plane block as a method for perioperative analgesia in high-risk pediatric patients undergoing anorectal and penile surgeries, to reduce the risks associated with systemic analgesia. This involves the administration of local anesthetics in the plane between the sacral multifidus muscle and the intermediate sacral crest bilaterally.

Inclusion Criteria:

• Parents or caregivers' acceptance.
• High-risk pediatric patients (the American Society of Anesthesiologists physical status class III-IV)
• Body mass index equal to 5%: 85% of the same age and sex.

Exclusion Criteria:

• Child with a contraindication to the regional block, such as infection at the site of injection, or coagulopathy.
• Pre-existing neurological disorders.