Ultrasound-Guided Caudal Epidural Block for Bilateral Testicular Ectopy and Circumcision in Child above 6 Years with Joubert Syndrome

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Fekih Hassen Amjed ◽  
◽  
Ben Fraj Asma ◽  
Blaiti Hajer ◽  
Ben Slimen Ahmed ◽  
...  
Keyword(s):  
Respiratory Control ◽  
Perioperative Period ◽  
Joubert Syndrome ◽  
Epidural Block ◽  
Opioid Use ◽  
Ultrasound Guided ◽  
Polygraphic Recordings ◽  
Caudal Epidural Block ◽  
Anesthesia Technique ◽  
Caudal Epidural

Background: Abnormal respiratory control has been clearly documented in infants and children with Joubert Syndrome (JS) by polygraphic recordings, characterized by episodes of apnea, tachypnea, and/or hyperpnea and the risk of recurrence of these episodes increase probably in perioperative period. In those cases, the choice of anesthesia technique and postoperative pain protocol, constitute a challenge for anesthesiologists. Case: We describe a case of successful ultrasound-guided Caudal Epidural Block (CEB) for children above 6 years with Joubert Syndrome undergoing bilateral testicular ectopy and circumcision avoiding opioid-use. Conclusions: Despite the difficulty to achieve CEB in child above 6 years, the ultrasound-guided can increase the success providing effective analgesia in-patient with a high-risk of respiratory failure as child with JS.

scholarly journals Transient bladder incontinence following ultrasound guided caudal epidural block

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Preethipriyadharshini Rajasekaran ◽  
Prasanna Vadhanan C ◽  
Nikhilesh Bokka
Keyword(s):  
Chronic Pain ◽  
Epidural Block ◽  
Sensory Loss ◽  
Chronic Pain Management ◽  
Ultrasound Guided ◽  
Lateral Sphincterotomy ◽  
Key Words Anesthesia ◽  
Caudal Epidural Block ◽  
Anesthesia Technique ◽  
Caudal Epidural

Caudal anesthesia is commonly used a regional anesthesia technique for sub-umbilical surgeries in pediatrics and for chronic pain management in adults. Ultrasound guided caudal epidural block improves the success rate with minimizes complications. We report a patient who underwent lateral sphincterotomy under ultrasound guided caudal epidural anesthesia and developed transient urinary incontinence with prolonged perineal sensory loss postoperatively. Key words: Anesthesia, Caudal epidural, Ultrasound. Citation: Preethipriyadharshini R, Vadhanan CP, Bokka N. Transient bladder incontinence following ultrasound   guided caudal epidural block. Anaesth. pain intensive care 2021;25(1):102–104; DOI: 10.35975/apic.v25i1.1437 Received: 17 October 2020; Reviewed: 4 November 2020; Accepted: 5 December 2020

scholarly journals Comparative study between ultrasound-guided pudendal nerve block and caudal epidural block anesthesia in children undergoing hypospadias surgery

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Waleed Abdalla Ibrahim Ahmed ◽  
Mohamed Hossam Eldin Hamdy Abd El W Shokier ◽  
Amr Ahmed Ali Kasem ◽  
Mohamed Hamed Abd El Aziz ◽  
Sherif Gorge Anees Saed
Keyword(s):  
Nerve Block ◽  
Pudendal Nerve ◽  
Epidural Block ◽  
Ultrasound Guided ◽  
Pudendal Nerve Block ◽  
Group A ◽  
Caudal Epidural Block ◽  
Group B ◽  
Hypospadias Surgery ◽  
Caudal Epidural

Abstract Background The aim of the study is to compare the effectiveness and safety of ultrasound-guided pudendal nerve block versus caudal epidural block as a part of multimodal analgesia in children undergoing hypospadias surgery. In this prospective, single-blinded study, 50 patients were randomized into 2 groups (25 each group) either receiving ultrasound-guided pudendal nerve block group A or caudal epidural block group B. In the pudendal nerve block group, patients were injected with 0.3 mL/kg 0.25% bupivacaine and 1 ug/kg fentanyl. In the caudal epidural group, patients were injected with 1 mL/kg 0.25% bupivacaine and 1 ug/kg fentanyl. Consumption of paracetamol was assessed during the first 24 h postoperatively. The “objective pain scale” done by Hannalah and Broadman was used to assess postoperative pain. Results This prospective randomized controlled single-blind clinical study was performed on total (50) ASA status I or II patients, of age 3 to 6 years scheduled for hypospadias surgery. For the primary outcome, there was no statistically significant difference found between the two studied groups regarding objective pain score at arrival to PACU with p value = 1.000 while there was a statistically significant increase in pain score in group B than group A at 6 h and 12 h with p value = 0.017 and 0.003, respectively. Also, no statistically significant difference found between the two groups after 18 h with p value = 0.238 may be due to receiving acetaminophen dose in group B. Finally there was a statistically significant increase found in objective pain score in group B at 24 h than group A with p value = 0.015. And there was a statistically significant increase in time to first analgesia in group A than group B with p value < 0.001 while there was a statistically significant increase in total dose of acetaminophen in group B than group A with p value < 0.001. Conclusion Both ultrasound-guided pudendal block and caudal epidural block are effective and safe methods for postoperative analgesia for children undergoing hypospadias surgery but ultrasound-guided pudendal block gives more postoperative pain control.

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