Comparison Sacral Erector Spinae Block Versus Caudal Block

Children aged 1-9 years undergoing hypospadias surgeries would be recruited in this randomized study.

Children would be monitored by electrocardiogram, pulse oximeter and non-invasive blood pressure.

After preoxygenation for three minutes, anesthesia would be induced with 8% sevoflurane inhalation in 50% oxygen and % 50 air ; 1ug/kg fentanyl and 3 mg/kg propofol is administered intravenously. Then laryngeal mask is inserted when conditions are satisfactory (jaw relaxed, lash reflex disappeared, no coughing, gagging, swallowing).After ethical committee approval, informed written consent will be obtained from all patients.

Consenting patients scheduled to have hypospadias surgery will be randomised to sacral erector spinae block or caudal block at the begin of surgery.

All patients heart rate,MAP and Oxygen saturation record intraoperatively. All patients will receive paracetamol if requirement for postoperative analgesia.All patient will transfer from PACU to day-surgery unit (DSU) if they achieved Modified Aldrete Score of ten.

All patients will be assessed postoperatively by a blinded investigator: in the postanesthesia care unit and at 30 min 1,2, 4, 6, 12, 24, hour postoperatively.FLACC score will be used.

Inclusion criteria

• Age 1-9
• ASA physical status I-II
• Undergoing unilateral low abdominal surgery

Exclusion criteria

• History of developmental delay or mental retardation, which will make observational pain intensity assessment difficult
• Parent refusal
• History of allergic reactions to local anesthetics
• Rash or infection at the injection site
• Anatomical abnormality
• Bleeding diatheses
• Coagulopathy
• History of diseases renal hepatic cardiac upper or lower airway neurologica