Thomas Wesley Templeton
Eduardo J. Goenaga-D
Leah B. Templeton
Douglas G. Ririe
Department of Anesthesiology, Wake Forest School of Medicine,
Winston-Salem, NC, USA
1. Drake-Brockman TF, Ramgolam A, Zhang G, Hall GL, von
Ungern-Sternberg BS. The effect of endotracheal tubes versus
laryngeal mask airways on perioperative respiratory adverse
events in infants: a randomised controlled trial. Lancet. 2017;389:
2. Templeton TW, Hoke LK, Templeton LB, Ririe DG, Rose DM, Bryan
YF. A comparison of 3 ventilation strategies in children younger than
1 year using a Proseal laryngeal mask airway: a randomized controlled
trial. J Clin Anesth. 2016;35:502-508.
Precision and efficacy of a new ultrasound-guided pudendal
nerve block technique in children
Sir—We read with great interest the article of Gaudet-Ferrand et al.
in a recent issue of the journal, in which the authors performed 120
blocks in 60 patients to test a new ultrasound-guided pudendal
nerve block technique in children.
The authors should be congratu-
lated for performing a well-designed study; however, there are some
questions regarding the trial that need to be clarified in order to
determine the validity of the results. First, the authors did not report
95% confidence intervals for the measured feasibility of the block. It
is possible that due to the small sample size, the lower end of the
confidence interval may suggest low feasibility for the new tech-
nique. Secondly, the authors used a 20% increase in blood pressure
or heart rate to detect success of the block but did not provide any
reference for that measure. It would be important to demonstrate
that anesthetic depth was not a confounding factor for the outcome.
Lastly, the lack of control group should be a strong enough reason
to preclude the authors to comment on the efficacy of the block.
We would welcome some clarifications from the authors to
clarify the validity of this important clinical study.
CONFLICT OF INTEREST
No conflicts of interest declared.
This research was carried out without funding.
Mark C. Kendall
Christopher J. Malgieri
Mark C. Kendall
Department of Anesthesiology, The Warren Alpert Medical School,
Brown University, Providence, RI, USA
1. Gaudet-Ferrand I, De La Arena P, Bringuier S, et al. Ultrasound-
guided pudendal nerve block in children: a new technique of ultra-
sound-guided transperineal approach. Pediatr Anesth. 2018;28:53-58.