Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Case Report

Pudendal nerve block for circumcision of pediatric patient with Pierre Robin Sequence: case report

Bloqueio do nervo pudendo para circuncisão de paciente pediátrico com Sequência de Pierre Robin: relato de caso

Munevver Kayhan, Pinar Kendigelen, Ayse Cigdem Tutuncu, Guner Kaya

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Pierre Robin Sequence (PRS) is a congenital condition characterized by micrognathia, glossoptosis, and cleft palate that presents with airway obstruction and developmental delay with or without other congenital anomalies. These patients’ anesthesia management is challenging because of difficult ventilation and intubation. Regional anesthesia methods should be considered for these patients on a case-by-case basis. This report presents primary use of regional anesthesia for circumcision of a 9-year-old boy with PRS.


Child;  Pierre Robin syndrome;  Regional anesthesia;  Case report


A Sequência de Pierre Robin (SPR) é uma condição congênita caracterizada por micrognatia, glossoptose e fenda palatina que se apresenta com obstrução das vias aéreas e atraso no desenvolvimento com ou sem outras anomalias congênitas. O manejo da anestesia desses pacientes é desafiador devido à dificuldade de ventilação e intubação. Métodos de anestesia regional devem ser considerados para esses pacientes caso a caso. Este relatório apresenta o uso primário de anestesia regional para circuncisão de um menino de 9 anos com SPR.


Criança; síndrome de Pierre Robin; Anestesia regional; Relato de caso


1. T.W. Templeton, E.J. Goenaga-Díaz, C.M. Runyan, et al. A generalized multistage approach to oral and nasal intubation in infants with Pierre Robin sequence: a retrospective review Pediatric Anesthesia, 28 (2018), pp. 1029-1034

2. F. Cladis, A. Kumar, L. Grunwaldt, et al. Pierre Robin Sequence: a perioperative review Anesth Analg, 119 (2014), pp. 400-412

3. B.J. Walker, J.B. Long, M. Sathyamoorthy, et al. Complications in pediatric regional anesthesia an analysis of more than 100,000 blocks from the pediatric regional anesthesia network Anesthesiology, 129 (2018), pp. 721-732

4. A.C. Tutuncu, P. Kendigelen, G. Ashyyeralyeva, et al. Pudendal nerve block versus penile nerve block in children undergoing circumcision Urol J, 15 (2018), pp. 109-115

5. P. Kendigelen, A.C. Tutuncu, S. Emre, et al. Pudendal versus caudal block in children undergoing hypospadias surgery: a randomized controlled trial Reg Anesth Pain Med, 41 (2016), pp. 610-615

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