Comparison of the effectiveness of saddle block and caudal block in patients undergoing transurethral resection of the prostate (TUR-P)

Objective: This study aimed to retrospectively compare the effects of saddle block and caudal block in patients who underwent TUR-P, evaluating their efficacy and safety during both the intraoperative and postoperative periods. Materials and Methods: This retrospective study was conducted by reviewing the medical records of patients who underwent TUR-P at Gaziantep University Şahinbey Research and Training Hospital between 2024 and 2025. According to the type of anesthesia previously administered, patients were retrospectively classified as saddle block "Group S" and caudal block "Group K". Demographic characteristics, intraoperative vital signs, sedation requirements, complications, postoperative VAS and Bromage scores, analgesic consumption, and additional analgesic needs were evaluated. Results: In our retrospective review, 37 patients who underwent TUR-P surgery received a saddle block and 35 patients received a caudal block. Seven patients from the saddle group and five from the caudal group were excluded due to incomplete data. There was no statistically significant difference between the groups in terms of demographic data, intraoperative additional sedation requirements, or intraoperative complications (p>0.05). However, intraoperative hemodynamic parameter changes were significantly higher in Group S compared to Group K (p<0.05). During the postoperative 24-hour period, VAS scores and tramadol consumption at the 3rd, 6th, and 12th hours were significantly lower in Group K (p<0.05). At the 3rd postoperative hour, muscle strength according to the Bromage scale was significantly weaker in Group S compared to Group K (p<0.05). Conclusion: In patients undergoing TUR-P surgery, both techniques were found to be effective and safe during the intraoperative period when performed with proper patient selection and by an experienced practitioner. However, in the postoperative period, caudal block provided better analgesic efficacy and patient comfort compared to saddle block.