Comparing caudal and penile nerve blockade using bupivacaine in hypospadias repair surgeries in children

Seyedhejazi, Mahin; Azerfarin, Rasoul; Kazemi, Fahime; Amiri, Maryam

doi:10.4103/0189-6725.91673

Cited by 18 publications

(12 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They found that the difference of post-operative pain between the two groups was insignificant for 2 hours then there was decrease in FLACC pain score in caudal group after 2 hours when compared to penile group, they concluded that the duration of post-operative analgesia was more in caudal group than that of DPNB also the supplementary analgesic need was minimized with insignificant incidence of complication in both groups. In addition, Mahin et al, [12] who aimed to compare caudal and penile nerve block using bupivacaine in post-operative pain control in hypospadias repair in children. They demonstrated that, caudal block has more success rate and more quality also longer duration of postoperative analgesia when compared to penile block.…”

Section: Discussionmentioning

confidence: 99%

Prospective Randomized Controlled Study Comparing Caudal Block versus Dorsal Penile Nerve Block as Postoperative Analgesia in Children Presented for Penile Surgery

Kandil¹,

Ragheb

Ismaiel

2018

The Medical Journal of Cairo University

View full text Add to dashboard Cite

Background: Caudal block is recommended for analgesia during and after surface operation on the penis, for example circumcision and hypospadias repair. The aim of this study was to compare caudal block versus dorsal penile block in children undergoing penile surgery, regarding duration and quality of post-operative analgesia. Aim of the Study: To compare caudal block versus dorsal penile block in children undergoing penile surgery, our primary outcome was the duration of postoperative analgesia while our secondary outcome was the quality of post-operative analgesia. Patients and Methods: 60 children, ASA I-II, 1-4 year's old undergoing penile surgery under general anesthesia were enrolled in the study. Children were randomly classified into two groups: (Group I) (penile group=30 patients) received a penile block using a mixture of lidocaine 3mg/kg (2%) and plain bupivacaine 1mg/kg (0.25%) on each side, Group II (caudal block group=30 patients) patients of this group received a caudal block using a mixture of lidocaine 3mg/kg (2%) and plain bupivacaine 1mg/kg (0.25%). Assessment of postoperative pain will be done by the Faces Pain Scale which is a self-report measure of pain intensity developed for children. It was adapted from the Faces Pain Scale to make it possible to score the sensation of pain on the widely accepted 0-to-10 metric, "0" equals "no pain" and "10" equals "very much pain". This done immediately postoperative and every 2H until 6H post-operative. Results: Faces pain score was significantly lower in group II at 2H, 4H and 6H post-operative with increase on the duration of block in Group II, also there was significant decrease in heart rate in Group II at 30min, 45min, 75min, 90min, 105min, 120min and 135min respectively from the start of surgery so there was significant increase of bradycardia and need of atropine in group. Conclusions: Caudal block seemed to be more effective in reducing post-operative pain score and decreasing the need

show abstract

Section: Discussionmentioning

confidence: 99%

Prospective Randomized Controlled Study Comparing Caudal Block versus Dorsal Penile Nerve Block as Postoperative Analgesia in Children Presented for Penile Surgery

Kandil¹,

Ragheb

Ismaiel

2018

The Medical Journal of Cairo University

View full text Add to dashboard Cite

show abstract

“…compared caudal block and dorsal penile block with bupivacaine and reported a failure rate of 1.7% in the caudal group and 2% in the penile group. In another study by Azerfarin et al using bupivacaine, additional analgesia was required by 1 (2.3%) patient in the caudal group, and 3 patients (7.4%) in the penile group and these patients were evaluated as failed block 16 . In our study, opioid was used as an additional analgesic in 8% of the patients undergoing caudal block, and in 8.3% of patients with dorsal penile block in the intraoperative period or in the recovery room and these blocks were considered to be failures.…”

Section: Discussionmentioning

confidence: 99%

Our Experiences of Pre-emptive Analgesia in Pediatric Penile Surgery: A Retrospective Comparison of the Analgesic Effects of Caudal Block and Dorsal Penile Block

Salık¹,

Akelma²

2019

Dicle Tıp Dergisi

View full text Add to dashboard Cite

Objective: Postoperative analgesia control is very important in circumcision patients, so preemptive analgesia methods are widely used for this purpose. The aim of this study was to compare patients undergoing circumcision applied with the most commonly used preemptive analgesia methods of caudal block or dorsal penile block, between January 2016 and September 2017 in our hospital. Methods: This retrospective study included 483 cases who underwent a circumcision operation at Ermenek State Hospital between January 2016 and September 2017 and were administered caudal block or dorsal penile block as preemptive analgesia. The anesthesia follow-up forms and nurse observation forms of the patients were examined and a record was made of demographic data, duration of surgery, duration of anesthesia, intraoperative and postoperative analgesic requirements and complications. From the clinics observation records of the patients, the time of first analgesic drug requirement and VAS scores were recorded. Results: Demographic data and hemodynamic data were similar in both groups. When the two groups were compared, in the caudal group, the duration of postoperative analgesia was longer, fewer patients required additional analgesia in the first 6-hour period, and the VAS scores were lower (p <0.05). In both groups, the number of failed blocks and complication rates were similar (p> 0.05). Conclusion: It is easy and safe to administer caudal block or dorsal penile block with bupivacaine for preventive analgesia in children undergoing circumcision. However, caudal block is more effective in providing postoperative analgesia.

show abstract

“…We performed network meta-analysis by using RevMan 5.4 and Stata 16.0 software. Initially, the event with a zero number 15,25 was recti ed to ensure the thorough completion of the data preprocessing stage. The study yielded dichotomous outcomes, for which odds ratios (ORs) and 95% con dence intervals (95% CIs) were computed.…”

Section: Satistical Analysismentioning

confidence: 99%

The impact on postoperative complications and analgesia of different nerve block techniques after hypospadias repair: a network meta-analysis

Feng,

Zheng,

Zheng

et al. 2023

Preprint

View full text Add to dashboard Cite

Hypospadias is the most common congenital anomaly of the genitourinary system, and hypospadias repair is one of the most common urological surgeries performed. Regional anesthesia utilized for this penile reconstructive surgery is typically either caudal block(CB) or penile nerve block(PB) or pudendal nerve block(PNB), but the evidence regarding whether these techniques will increase postoperative complications is still controversial. Therefore we aimed to assess the association between block type and the incidence of postoperative complications. Relevant studies were identified by searching electronic databases, including randomized controlled trials, case-control, and cohort studies from inception until June 10th, 2023 and performed this network meta-analysis. A total of 29 studies were included, involving a population of 5284 pediatric patients. Our network meta-analysis revealed that PB may be the optimal nerve block technique to minimize postoperative complications in hypospadias repair surgery. Regarding postoperative analgesic effects, PNB ranked first to reduce consumption of postoperative analgesics, followed by PB. Therefore PB may be one of the most effective techniques to decrease complication rates in hypospadias repair, and significantly reduced reliance on postoperative analgesics of these patients. However, due to clinical and methodology heterogeneity among included studies, further validation is warranted.

show abstract

Comparing caudal and penile nerve blockade using bupivacaine in hypospadias repair surgeries in children

Abstract: Without ultrasonography and with blind block, with anatomic landmarks only, the caudal block success rate is high and if there is no contraindication for caudal block, it is the best choice in children under 6 years old (or 25 kg) for hypospadias repair.

Cited by 18 publications

References 13 publications

Prospective Randomized Controlled Study Comparing Caudal Block versus Dorsal Penile Nerve Block as Postoperative Analgesia in Children Presented for Penile Surgery

Prospective Randomized Controlled Study Comparing Caudal Block versus Dorsal Penile Nerve Block as Postoperative Analgesia in Children Presented for Penile Surgery

Our Experiences of Pre-emptive Analgesia in Pediatric Penile Surgery: A Retrospective Comparison of the Analgesic Effects of Caudal Block and Dorsal Penile Block

The impact on postoperative complications and analgesia of different nerve block techniques after hypospadias repair: a network meta-analysis

Contact Info

Product

Resources

About