Background and Goal of Study:The objective is to compare the penile block with the pudendal block in terms of feasibility and effectiveness, during pediatric prepuce surgery.

Materials and Methods: After approval of the hospital's ethics committee and parental consent, we conducted a randomized prospective study, including 60 patients aged 2 to 5 years, classified as ASA 1 and admitted for foreskin surgery. We excluded patients who experienced block failure, defined as an increase in mean arterial pressure greater than 25% from baseline, or an anesthetic or surgical complication. The children were randomized into 2 equal groups of 30 patients each GR (penile block by the loss of resistance technique) and GN (pudendal block under neurostimulation). All patients received a 0.2ml / kg dose of 0.25% Bupivacaine Anesthetic Mix and 1% Nonadrenaline Xylocaine on each side. Nalbuphine was administered intranasally if pain persisted (CHEOPS> 7). Parents were contacted by phone the following day for evaluation of the quality of analgesia. We collected the anthropometric parameters of the patients, the duration of the block procedure and the quality of the analgesia (CHEOPS from 4 to 13) as well as the satisfaction of the surgeons and the parents. Statistical analysis was performed by SPSS 22 (p <0.05).

Results and Discussion:

	GR	GN	p
Age (year)	3.7±1.2	3.9±1.5	>0.5
Weight(Kg)	15.1±4.3	16.6±5.7	>0.5
Procedure time(min)	4.5±1.1	4.9±1.3	>0.5
CHEOPS (4 -13)	6.7±1.9	5.9±1.3	0.029
Antalgic remedies	7/30	3/30	0.031
1st analgesic dose (min)	230±63	290±41	0.037
dysuria	1/30	4/30	0.041
surgeons satisfaction	24/30	30/30	0.01
parents satisfaction	29/30	25/30	0.027

Conclusion:Pudendal block provides better analgesia and surgeon satisfaction by decreasing the risk of erection compared to the penile block, but it causes a higher risk of dysuria which, even if it is statistically insignificant, would be the cause less satisfying parents

11 / Comparison of pudendal block with penile block during pediatric prepuce surgery