الفهرس 
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Abstract
Hypospadias repair is a painful intervention that is
frequently performed in pediatric patients. It is generally
performed under general anesthesia in order to eliminate fear and
anxiety.
Using optimal analgesic regimen provide safe and effective
analgesia, reduce postoperative stress response and accelerate
recovery from surgery.
Many regional anesthesia techniques including the caudal
epidural block, the classical dorsal penile nerve block (landmarkbased)
have been used for hypospadias repair surgeries to
minimize pain and complications.
In this study, the aim is to compare postoperative analgesia
between caudal block and penile block with bupivacaine in
elective hypospadias repair cases.
The study was conducted on 60 randomly chosen children
in Ain Shams University Hospitals after approval of the medical
ethical committee. Patients were divided randomly into two
groups, each group consisted of 30 patients group C and group P.
Summary
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After preoperative assessment and obtaining baseline vital
data, all patients received general anesthesia. Patients in group C
received caudal block (0.5ml/kg) of 0.25% bupivacaine. Patients
in group P received penile block (0.5ml/kg) of 0.25%
bupivacaine.
This current study revealed also that there was no statistical
significant difference between two groups regarding
hemodynamics including Systolic and diastolic blood pressure
(P>0.05) and HR (P>0.05).
Postoperative pain was evaluated by FLACC pain score at
PACU, 2, 4 and 8, 12, 16 and 24 hrs. There was a significant
increase in the pain score in group C starting from the fourth hour
postoperativly and thereafter every hour, while the lowest pain
scores were recorded in group P (P<0.05). Also, the time to first
need for rescue analgesia was significantly shorter in group C
(240 +/-105 min) compared with group P (720 +/-301) (P >
0.01).The total rescue analgesic requirement was significantly
lower in group P (168.26 +/-22.69) than group C (573.8+/- 124.1)
(P < 0.01).Postoperative time of ambulation was significantly
lower in group C (6.95+/- 3.22) compared with group P (5.28+/-
1.99) (P < 0.01).