Penile Surgery-Related Pain, Postoperative Pain Management
Conditions
Keywords
Pudendal Nerve Block, Pediatric Regional Anesthesia, Neurostimulation
Brief summary
This prospective observational study aims to investigate the relationship between anatomical parameters-specifically the distance from the anus to the needle insertion point and the depth required to reach the pudendal nerve-during neurostimulation-guided pudendal nerve block and patients' age, height, and weight in children undergoing penile surgery.
Detailed description
The pudendal nerve originates from the sacral nerve roots Sacral2-Sacral4 and provides sensory and motor innervation to the penile and perineal regions. Effective postoperative analgesia is essential in pediatric penile surgeries. Pudendal nerve block may provide longer-lasting and more effective analgesia compared to caudal or penile blocks. However, due to age- and size-related anatomical variability in children, data regarding optimal needle insertion distance and depth to reach the pudendal nerve are limited. In this study, neurostimulation will be used to confirm pudendal nerve localization, and anatomical measurements will be analyzed in relation to demographic parameters.
Interventions
PROCEDURENeurostimulation-Guided Pudendal Nerve Block
Bilateral pudendal nerve block is performed under general anesthesia with neurostimulation guidance. Anatomical measurements, including distance from anus to needle insertion point and nerve depth, are recorded for each patient. Bupivacaine 0.25% is used at 0.25 ml/kg per side, with a maximum total dose of 2 mg/kg.
Sponsors
Istanbul University - Cerrahpasa
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Children aged 1-18 years * Scheduled for penile surgery (e.g., hypospadias, phimosis) * Planned to receive neurostimulation-guided pudendal nerve block * Patient and parents/legal guardians willing to participate under general anesthesia
Exclusion criteria
* Patients with incomplete measurement data * Cases where successful nerve block cannot be performed or nerve stimulation is not detectable at currents ≥1.5 mA * Patients or parents/legal guardians who refuse pudendal nerve block * Patients with pelvic deformities or neuromuscular disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Horizontal distance from anus to needle insertion point and Depth from skin surface to pudendal nerve | During pudendal nerve block procedure | The horizontal distance from the anus to the needle insertion point is measured in centimeters for each patient using neurostimulation-guided pudendal nerve block. Measurements are recorded separately for the right and left sides.The depth from the skin surface to the pudendal nerve is measured in centimeters using neurostimulation guidance. Measurements are recorded separately for the right and left sides. The relationship of this distance and the association of nerve depth with patient age, height, and weight will be analyzed. |
Countries
Turkey (Türkiye)
Contacts
Primary ContactMunevver Kayhan, Lecturer Doctor
Backup ContactPinar Kendigelen, Professor Doctor
Outcome results
None listed