Comparison of Sacral ESP Block and Caudal Block in Pediatric Hypospadias Surgery

Hypospadias surgery in pediatric patients requires effective postoperative analgesia to ensure patient comfort and reduce perioperative stress. Caudal epidural block is widely used for analgesia in pediatric urological procedures; however, alternative regional techniques such as the sacral erector spinae plane (ESP) block have recently gained attention. This prospective comparative study aims to compare the analgesic efficacy of sacral ESP block and caudal epidural block in pediatric patients undergoing hypospadias surgery. Participants will be allocated to receive either sacral ESP block or caudal epidural block according to the study protocol. The primary outcome will be postoperative pain scores within the first 24 hours after surgery. Secondary outcomes will include total analgesic consumption, time to first rescue analgesia, and block-related complications.

Inclusion Criteria: 1. Male patients aged between 6 months to 7 years 2. Scheduled for hypospadias repair surgery 3. ASA physical status I-II 4. No known allergy to local anesthetic agents 5. No contraindications to peripheral nerve blocks 6. Written informed consent obtained from parents or legal guardians Exclusion Criteria: 1. Known congenital coagulopathy 2. Known allergy to local anesthetic agents 3. Severe systemic disease (ASA III-IV) 4. Severe organ failure 5. Neurological disorders