CLINICAL TRIAL article
Front. Pediatr.
Sec. Pediatric Surgery
Volume 13 - 2025 | doi: 10.3389/fped.2025.1607309
This article is part of the Research TopicPediatric Wounds And Tissue Engineering/RegenerationView all 4 articles
Comparing the analgesic effects of ultrasound-guided caudal block and dorsal penile nerve block in pediatric concealed penis correction surgery：A randomized controlled trial
Provisionally accepted
- 1Department of Anesthesiology, Shunde Heping Surgical Hospital, Foshan, China
- 2Department of Anesthesiology, The Affiliated Shunde Hospital of Jinan University, Foshan, Guangdong Province, China
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Background: Effective perioperative analgesia is critical for pediatric patients undergoing concealed penis correction surgery. Despite the utility of regional techniques like caudal block (CB) and dorsal penile nerve block (DPNB), evidence comparing their efficacy in this population remains limited. This study aimed to compare ultrasound-guided CB and DPNB for perioperative analgesia in pediatric concealed penis surgery.In this prospective, double-blind, randomized controlled trial, 86 children (aged 5-12 years, ASA I-II) were allocated to CB (n=44) or DPNB (n=42) groups. All the children were induced with general anesthesia using propofol and sevoflurane, followed by laryngeal mask placement. Anesthesia was maintained with sevoflurane inhalation (spontaneous respiration preserved) under depth-of-anesthesia monitoring. The CB group received ultrasound-guided CB, while the DPNB group underwent bilateral dorsal penile nerve block, both using 0.2% ropivacaine. Primary outcomes included postoperative analgesic requirements within 24 hours. Secondary outcomes encompassed pain scores, hemodynamic parameters, adverse events, and satisfaction.The CB group demonstrated significantly lower analgesic requirements (38.6% vs. 71.4%, p=0.005) within 24 hours and reduced early postoperative pain scores (at 2,4,6 hours, p < 0.05). Intraoperatively, CB required fewer anesthesia deepening (20.5% vs. 52.4%, p=0.004) and shorter surgical duration (71.1 ± 13.7 vs. 79.7 ± 9.9 min, p = 0.001).Adverse events, including tachycardia (2.3% vs. 26.2%, p=0.004) and body movements (6.8% vs. 42.9%, p<0.001), were less frequent with CB. Parental and surgeon satisfaction were higher in the CB group (p=0.049 and p<0.001).Conclusions: Ultrasound-guided CB provides superior perioperative analgesia, fewer complications, and higher satisfaction compared to DPNB in pediatric concealed penis surgery, supporting its preference for this specific procedure in clinical practice.
Keywords: Caudal block, Dorsal penile nerve block, Pediatric analgesia, regional anesthesia, concealed penis surgery
Received: 07 Apr 2025; Accepted: 08 Jul 2025.
Copyright: © 2025 Lin, Shao, Li, Chen, Li, Wu, Liu and Zhongqi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhang Zhongqi, Department of Anesthesiology, The Affiliated Shunde Hospital of Jinan University, Foshan, Guangdong Province, China
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