Background: Surgery to repair hypospadias is often done when a child is young. Due to the huge wound area and broad nerve destruction involved during surgical repair, postoperative pain may be quite severe. There is disagreement over the best effective and safe analgesic technique for managing perioperative pain in children in these cases. Objectives: To assess the effectiveness & safety of caudal versus penile block in children having hypospadias surgery repair under general anesthesia (GA). Methods: A prospective randomized comparative study of 150 male pediatric patients aged between 4 to 8 years planned for hypospadias repair at Alzahraa University Hospital was conducted. Participants were split into a control group that received GA with fentanyl, a caudal group getting caudal block following GA, and penile block group who received penile block after GA. Postoperative Faces Pain Scale-Revised (FPS-R), total nalbuphine amount within the first 24 hours after surgery was measured and any complications were noted. Results: Without a significant variation among the caudal and penile groups, the patients receiving GA alone needed postoperatively a considerably greater nalbuphine dosage than the other two groups. The children getting caudal recovered earlier than the control and penile group patients. At 30 minutes, 1, 2, 4, and 6 hours postoperatively, FPS-R was significantly greater in the control group contrasted with the caudal & penile groups, although no significant distinction was observed among the caudal and penile groups. Furthermore, a considerably higher proportion of cases in the control group (60%) had tachycardia as contrasted with the caudal and penile groups (10% & 22%, respectively, P-value less than 0.001). Conclusions: Penile block may be used to achieve the same analgesic effectiveness as the caudal block, in pediatric cases having hypospadias corrective operation. Although the caudal block group had better hemodynamic stability with early recovery from anesthesia.

Caudal, penile block, Hypospadias, Post-operative pain, Faces Pain Scale-Revised (FPS-R).