Patient Position: The patient lies on his back.

Indications: Analgesia during and after surface operations on the penis: circumcision, phimosis; also suitable for pain management following hypospadia repair, while it is not sufficient for the surgery itself, caudal anesthesia is preferable.

Needle Size: A short beveled needle (e.g., a caudal needle).

Volume: 0.1 mL/kg of ropivacaine 0.2% for children up to 7 years, levobupivacaine 0.5% for older children for each side without epinephrine (absolutely contraindicated because of the risk of ischemia of the dorsal arteries of penis) up to a maximum of 5 mL per side.

Anatomic Landmarks: Pubic symphysis (Figs. 51-1, 51-2, 51-3).