Low-concentration, low-dose lidocaine in ultrasound-guided sacral anesthesia reduces postoperative agitation and delirium in children undergoing hidden penis and hypospadias surgery: A prospective, randomized, controlled study

Postoperative agitation or postoperative delirium (EA/ED) has a high incidence among pediatric patients undergoing anesthesia and surgery. In this study, we aimed to evaluate the effects of sacral anesthesia with 0.125 mL/kg of 1% lidocaine on EA/ED in children undergoing hidden penis and hypospadias surgery. Sixty children aged 1-6 years undergoing elective hidden penis or hypospadias surgery were enrolled in the study. The postoperative EA/ED score and incidence; Face, Legs, Activity, Cry, and Consolability scale; perioperative general information and vital signs; and the occurrence of adverse events were analyzed. Ultrasound-guided sacral anesthesia in children resulted in more stable vital signs, postoperative pain relief, fewer complications, and lower incidence of EA/ED. In conclusion, the use of 0.125 mL/kg of 1% lidocaine combined with laryngeal mask general anesthesia significantly reduced the incidence of EA/ED in children undergoing hidden penis and hypospadias surgery while ensuring high perioperative safety.