Comparison of Caudal Block and Sacral Erector Spinae Plane Block With Dexmedetomidine in Pediatric Penile Hypospadias Repair

"* Position: Prone with a pillow under the pelvis.~* Ultrasound: High-frequency linear probe placed parasagittal, 1-1.5 cm lateral to the midline at S2-S3. Structure identified: skin → subcutaneous tissue → erector spinae muscle → sacral lamina.~* Technique: An echogenic 22G needle will be advanced in-plane until contact with the sacral lamina under the erector spinae muscle. After hydro dissection with saline, the study drug will be injected with visible spread along the fascial plane. The same procedure will be repeated contralaterally.~* Dose: Bupivacaine 0.25% total 1 mL/kg divided equally on both sides, dexmedetomidine 1 μ g/kg divided equally."

"* Position: Prone with a pillow under the pelvis.~* Ultrasound: High-frequency linear probe placed parasagittal, 1-1.5 cm lateral to the midline at S2-S3. Structure identified: skin → subcutaneous tissue → erector spinae muscle → sacral lamina.~* Technique: An echogenic 22G needle will be advanced in-plane until contact with the sacral lamina under the erector spinae muscle. After hydro dissection with saline, the study drug will be injected with visible spread along the fascial plane. The same procedure will be repeated contralaterally.~* Dose: Bupivacaine 0.25% total 1 mL/kg divided equally on both sides, dexmedetomidine 1 μ g/kg divided equally."