{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:04:33Z","timestamp":1787065473961,"version":"build-2736575974"},"reference-count":16,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2022,8,20]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Caudal block is frequently performed to provide analgesia for hypospadias repair. Literature suggests that pudendal block provides prolonged postoperative analgesia as compared with caudal block in children between 2 and 5\u2009years. We compared the efficacy of pudendal and caudal blocks in children less than 2\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>60 children scheduled for hypospadias repair received standard general anesthesia along with either pudendal or caudal block (groups of 30 each). Variables collected were demographic data, block time, operating room time, intraoperative pain medication need, pain assessment score and medication need in the recovery room and pain assessment at home.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>Groups were demographically similar. No differences were observed in the following recorded times (minutes): block procedure (caudal: 9.5\u00b14.0, pudendal: 10.6\u00b14.1, p=0.30), anesthesia (caudal: 17.3\u00b15.3, pudendal: 17.7\u00b14.3, p=0.75), total OR (caudal: 171\u00b135, pudendal: 172\u00b141; p=0.95) and postanesthesia care unit (PACU) stay (caudal: 88\u00b137, pudendal: 86\u00b142; p=0.80). Additionally, no differences were observed in rescue pain medication need in the operating room (caudal: 0, pudendal: 2 (p=0.49), in PACU (caudal: 4, pudendal: 4, p=0.99), pain assessed at home, time to pain level 2 (caudal: 13.93\u00b18.9, pudendal: 15.17\u00b18.7), average pain scores (p=0.67) and total pain free epochs (pain level of zero) (p=0.80) in the first 24 hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In children less than 2\u2009years, both blocks provide comparable intraoperative and postoperative pain relief in the first 24 hours after hypospadias surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03145415\">NCT03145415<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2022-103680","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T11:26:15Z","timestamp":1662636375000},"page":"744-748","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Nerve stimulation guided bilateral pudendal nerve block versus landmark-based caudal block for hypospadias repair in young children: a prospective, randomized, pragmatic trial"],"prefix":"10.1136","volume":"47","clinical-trial-number":[{"clinical-trial-number":"nct03145415","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1570-7418","authenticated-orcid":false,"given":"Dinesh K","family":"Choudhry","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Shriners Hospitals for Children, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry","family":"Heredia","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, St Francis Hospital, Wilmington, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce Randall","family":"Brenn","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Shriners Hospitals for Children, Philadelphia, Pennsylvania, USA"},{"name":"Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennesee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Brown","sequence":"additional","affiliation":[{"name":"Anesthesiology, Nemours Children's Hospital Delaware, Wilmington, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6031-3787","authenticated-orcid":false,"given":"Norman F","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Anesthesiology, Nemours Children's Hospital, Orlando, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milicent C","family":"Whaley","sequence":"additional","affiliation":[{"name":"Anesthesiology, Nemours Children's Hospital, Orlando, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadiq S","family":"Shaik","sequence":"additional","affiliation":[{"name":"Anesthesiology, Nemours Children's Hospital, Orlando, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A","family":"Hagerty","sequence":"additional","affiliation":[{"name":"Urology, Nemours Children's Hospital Delaware, Wilmington, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Bani Hani","sequence":"additional","affiliation":[{"name":"Urology, Nemours Children's Hospital Delaware, Wilmington, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,9,8]]},"reference":[{"key":"2025101111294836000_47.12.744.1","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.1016\/j.juro.2011.01.032","article-title":"Outcomes of hypospadias repair in older children: a prospective study","volume":"185","author":"Ziada","year":"2011","journal-title":"J Urol"},{"key":"2025101111294836000_47.12.744.2","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.bja.2018.11.030","article-title":"Caudal epidural blocks in paediatric patients: a review and practical considerations","volume":"122","author":"Wiegele","year":"2019","journal-title":"Br J Anaesth"},{"key":"2025101111294836000_47.12.744.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03448.x"},{"key":"2025101111294836000_47.12.744.4","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1213\/ANE.0b013e3182a8ee52","article-title":"The 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for urethrocutaneous fistula in hypospadias surgery","volume":"9","author":"Yildiz","year":"2013","journal-title":"J Pediatr Urol"},{"key":"2025101111294836000_47.12.744.12","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1111\/pan.13119","article-title":"The association between caudal anesthesia and increased risk of postoperative surgical complications in boys undergoing hypospadias repair","volume":"27","author":"Taicher","year":"2017","journal-title":"Paediatr Anaesth"},{"key":"2025101111294836000_47.12.744.13","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1111\/anae.13463","article-title":"Impact of caudal block on postoperative complications in children undergoing tubularised incised plate urethroplasty for hypospadias repair: a retrospective cohort 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Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2022-103680","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:29:53Z","timestamp":1760207393000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2022-103680"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,8]]},"references-count":16,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,10,25]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/rapm-2022-103680"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2022-103680","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,8]]}}}