Effect of anesthesia for hypospadias repair on perioperative complications

This is a retrospective cohort study looking at surgical complication rates for hypospadias repairs depending on type of anaesthesia given, GA + caudal, GA + penile block and GA only. They wanted to review their own data from 26 years of practice to see if it reflected the results of recent papers on the topic. Papers from Korea, India and the US published in Anaesthesia and Paediatric Anaesthesia suggested that GA + caudal could be associated with an increase in postoperative surgical complications.

This study reviewed charts for 63 patients covering 353 procedures and excluded urethral dilatation and urethrocutaneous fistula repair.

Using standard statistical analyses for non-parametric data they came to the following conclusion: There was no difference in complication rates between the three anaesthetic techniques. However a significant difference was found for hypospadias type (P = 0.003) and surgical technique (P < 0.001). Fistula formation was found to be affected by anaesthetic type with a trend towards the use of caudal (P = 0.08) while stricture formation trended towards reduction (P = 0.12) for GA + caudal and GA + penile block.

This group concluded that anaesthetic technique has minimal effect on perioperative complications for children undergoing hypospadias repair though more complex and proximal surgery is usually accompanied by a caudal for adequate analgesia which may explain this effect.

Reviewed by: Meredith Betts