AI Summary & Key Takeaways
AI InsightIn this retrospective cohort study, landmark-guided bilateral pudendal nerve block was associated with lower postoperative pain scores at 6 hours and reduced analgesic consumption compared with dorsal penile block in paediatric urogenital surgery.
📌 3 Key Takeaways
Abstract
Postoperative pain control is a fundamental component of optimal perioperative management in patients undergoing paediatric urogenital surgery. Although pudendal nerve block and dorsal penile block are commonly used regional techniques, comparative data—particularly for landmark-guided approaches—remain limited. Therefore, this study aimed to compare the analgesic effectiveness of bilateral pudendal nerve block and dorsal penile block. This retrospective cohort study included children aged 2–10 years who underwent elective urogenital surgery under general anaesthesia between January 2024 and November 2025. Patients were grouped according to the regional block technique documented in the anaesthesia records: bilateral landmark-guided pudendal nerve block (PDB) or penile nerve block (PNB). Postoperative pain was assessed using the FLACC scale in the post-anaesthesia care unit and at 2, 6, 12 and 24 hours. Total paracetamol consumption and rescue analgesia were recorded. Ninety-nine patients were analysed (PDB: 45; PNB: 54). FLACC scores were lower in the PDB group at 6 hours (0.84±1.15 vs 1.72±1.37, p<0.001). Total paracetamol consumption was lower in the PDB group (109.6±73.9 mg vs 188.3±85.4 mg, p<0.001), and fewer patients required rescue analgesia (53.3% vs 74.1%, p=0.03). In this retrospective cohort study, landmark-guided bilateral pudendal nerve block was associated with lower postoperative pain scores at 6 hours and reduced analgesic consumption compared with dorsal penile block in paediatric urogenital surgery.
Özet
Pediatrik ürogenital cerrahi geçiren hastalarda postoperatif ağrı kontrolü, optimal perioperatif yönetimin temel bileşenlerinden biridir. Pudendal sinir bloğu ve penil blok yaygın kullanılan bölgesel teknikler olmakla birlikte, özellikle landmark kılavuzlu yaklaşımlara ilişkin karşılaştırmalı veriler sınırlıdır. Bu nedenle, bu çalışmada bilateral pudendal sinir bloğu ile penil bloğun analjezik etkinliği karşılaştırılmıştır. Ocak 2024 – Kasım 2025 tarihleri arasında genel anestezi altında elektif ürogenital cerrahi geçiren 2–10 yaş arası çocuklar retrospektif olarak incelendi. Hastalar uygulanan blok tipine göre iki gruba ayrıldı. Postoperatif ağrı FLACC skoru ile değerlendirildi. Analjezik tüketimi ve kurtarıcı analjezi gereksinimi kaydedildi. Toplam 99 hasta değerlendirildi (PDB:45, PNB:54). 6. saatte FLACC skoru PDB grubunda daha düşüktü (0.84±1.15 vs 1.72±1.37, p<0.001). Toplam parasetamol tüketimi ve kurtarıcı analjezi ihtiyacı PDB grubunda daha azdı. Bu retrospektif kohort çalışmada, landmark kılavuzlu bilateral pudendal sinir bloğu, pediatrik ürogenital cerrahide postoperatif 6. saatte daha düşük ağrı skorları ve daha düşük analjezik tüketimi ile ilişkili bulunmuştur.