Background and Goal of Study: Neurostimulation is possible in the pudendal block considering that it is a mixed nerve. 
The aim of our study is to compare the efficacy of neurostimulation compared to the loss of resistance in the pudendal blocks techniques during circumcision surgery and anterior hypospadias in children.
Materials and Methods: Following Ethical Committee approval and parental informed consent, we conducted a prospective randomized study, including children aged from 1 to 9 years, scheduled for hypospadias surgery , urethral fistula repair or circumcision. Patients with known allergy to anesthetic products, coagulopathy or infection at the site of puncture were not included, patients with intraoperative analgesic or surgical complication were excluded. The patients were randomly assigned into two groups: Group 1: Block without neurostimulation, it 's the technique of loss of resistance that signals the crossing of the obturator aponeurosis; Group 2: block with neurostimulation .The expected response stimulation was an up and down movement of the penis. A mihospitalization of 6 hours postoperatively was required. Patients received paracetamol 15 mg per kg if CHEOPS> 7 and nalbuphine if persistent pain (CHEOPS> 7). Patients were contacted at home by telephone to assess the analgesic recquirement. The efficiency of the pudendal block, the quality of postoperative analgesia evaluated by the CHEOPS score (awakening, H1, H2, H4, H6) , the need for analgesics in the hospital and at home and the parents satisfaction were recorded. The statistical analysis was carried out by SPSS software 19 ( p is significant if < 0.05.
Results and Discussion: Seventy-one patients were included in the study: group 1 (n = 35) and group 2 (n = 36). The mean age of the patients was 42 months [8-108] and the patients were all classified as ASA I. The two groups were comparable for the demographic characteristics (age, ASA and type of surgery).The Block rate failure was comparable in the two groups. At the hospital, there was no significant difference in the use of analgesics between the two groups. At home, 23 patients (14 in group 1 and 9 in group 2) have received paracetamol, with no significant difference between the two groups. No child needed the use of nalbuphine .Parental satisfaction was insignificant in two groups (82.8% versus 97.2, p =0.052).
Conclusion(s): Neurostimulation doesn´t increase the effectiveness of the pudendal block.

Neurostimulation in the pudendal nerve block in pediatric surgery: a randomized controlled trial