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Study Objective: To evaluate and compare the analgesic effect of ultrasound-guided erector spinae plane (ESP) block with ultrasound-guided Quadratus Lumborum Block in pediatric lower abdominal surgeries., Design: Randomized, prospective, double-blinded trial., Setting: Operating room and surgical ward., Patients: Sixty patients, aged 1 to 7 years with ASA scores of I-II scheduled for elective lower abdominal surgery were included in the study., Interventions: Patients were randomized into two groups as ESPB group and QLB group. Ultrasound guided ESP block at L1 vertebral level was performed preoperatively using 0.5 ml/kg 0.25% bupivacaine (max 20 ml) to the patients in ESPB group. And ultrasound guided QLB block with transmuscular approach was performed preoperatively using 0.5 ml/kg 0.25% bupivacaine (max 20 ml) to the patients in QLB group., Measurements: Face, Legs, Activity, Cry and Consolability (FLACC) scores for pain were recorded at 0, 1, 3 and 6 h postoperatively. Analgesic requirements and time to first analgesic requirement were also recorded., Main Results: Fifty-seven patients were included in the final analyses. No significant difference was determined between the groups' FLACC scores at 0, 1, 3 or 6 h postoperatively (p > 0.05). No significant difference was also determined in times to first analgesia between the groups (p > 0.05)., Conclusions: This study shows that the ESPB provides similar postoperative analgesia to the QLB in pediatric patients undergoing lower abdominal surgery. Clinicians could decide according to their clinical experiences. CLINICAL TRIALS: https://clinicaltrials.gov/ct2/show/NCT03463382., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background and Aims: Hypospadias is a common congenital malformation in pediatric patients. Surgical repair of this malformation is a painful procedure and has long-term effects. Pudendal and penile nerve blocks are commonly preferred techniques for maintaining postoperative analgesia. However, the conventional landmark-based penile block technique involves numerous potential complications and provides a shorter analgesic period compared to the pudendal block. A promising ultrasound-guided dorsal penile nerve block was recently described. We aimed to compare the analgesic effectiveness of ultrasound-guided penile nerve block with that of neurostimulator-guided pudendal nerve block., Method: Thirty-three patients aged 1-7 years were included in this prospective, double-blinded, randomized controlled trial. Patients were divided into two groups and received either ultrasound-guided dorsal penile nerve block or neurostimulator-guided pudendal nerve block. All blocks were performed by the same two anesthesiologists, and the same surgeons performed the surgical procedures. The Face, Legs, Activity, Cry, and Consolability (FLACC) scale was used for postoperative pain management. The primary outcome of the study was time to first analgesic requirement. Secondary outcomes were FLACC scores at different time points, and types and cumulative doses of analgesic drugs., Results: Dorsal penile nerve block provided longer analgesia than pudendal nerve block (32.29 ± 5.47 hours and 21.13 ± 3.53 hours, respectively; differences in mean: 11.16, 95% CI: 7.873-14.465) (P < .001). FLACC scores at the time of first analgesic requirement were significantly lower in dorsal penile nerve block group than pudendal nerve block group (median [IQR]: 2 [2-2.5] and 3 [3-5], respectively; differences in median: -1, 95% CI: -1.851 to -0.149) (P < .001)., Conclusion: Ultrasound-guided dorsal penile nerve block provided a longer analgesic period and reduced opioid consumption compared to neurostimulator-guided pudendal nerve block., (© 2019 John Wiley & Sons Ltd.)