Comparing Pudendal Nerve Blocks and Caudal Blocks for Pediatric Urological Surgeries: A Systematic Review and...

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Pain Management

Background:

• Pudendal nerve blocks (PNBs) and caudal blocks (CBs) are common regional anesthesia techniques for pediatric urological procedures.
• A comparative analysis of their efficacy and safety in this population is warranted.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy and safety of PNBs versus CBs in pediatric urological surgeries.
• To compare postoperative pain scores, analgesia duration, and complication rates.

Main Methods:

• Systematic review and meta-analysis following PRISMA guidelines.
• Searched PubMed, Scopus, and Cochrane CENTRAL for relevant RCTs and observational studies.
• Included 7 studies with 644 pediatric patients; data extracted and analyzed using Review Manager 5.4.

Main Results:

• PNBs significantly reduced postoperative pain scores at 6, 12, and 24 hours compared to CBs (MD -1.83, -2.10, -2.94).
• PNBs demonstrated prolonged analgesia duration, reduced opioid consumption, and lower incidence of urinary retention and rescue analgesia.
• No significant differences were found in motor block or systemic side effects between PNBs and CBs.

Conclusions:

• PNBs offer superior pain relief and reduced opioid consumption and complications compared to CBs in pediatric urological surgeries.
• These findings support the use of PNBs as an effective regional anesthesia technique in this patient group.
• Further research is recommended to optimize pain management strategies.