Comparison of Postoperative Analgesic Efficacy of Caudal Block versus Dorsal Penile Nerve Block with Levobupivacaine for Circumcision in Children

Abstract

BackgroundCircumcision is a painful intervention frequently performed in pediatric surgery. We aim to compare the efficacy of caudal block versus dorsal penile block (DPNB) under general anesthesia for children undergoing circumcision.MethodsThis study was performed between July 1, 2009 and October 16, 2009. Fifty male children American Society of Anesthesiolgists physical status classification I, aged between 3 and 12 were included in this randomized, prospective, comparative study. Anesthetic techniques were standardized for all children. Patients were randomized into 2 groups. Using 0.25% 0.5 ml/kg levobupivacain, we performed DPNB for Group 1 and caudal block for Group 2. Postoperative analgesia was evaluated for six hours with the Flacc Pain Scale for five categories; (F) Face, (L) Legs, (A) Activity, (C) Cry, and (C) Consolability. For every child, supplemental analgesic amounts, times, and probable local or systemic complications were recorded.ResultsNo significant difference between the groups (P > 0.05) was found in mean age, body weight, anesthesia duration, FLACC pain, and sedation scores (P > 0.05). However, on subsequent measurements, a significant decrease of pain and sedation scores was noted in both the DPNB group and the caudal block group (P < 0.001). No major complication was found when using either technique.ConclusionsDPNB and caudal block provided similar postoperative analgesic effects without major complications for children under general anesthesia.

Comparison of Postoperative Analgesic Efficacy of Penile Block, Caudal Block and Intravenous Paracetamol for Circumcision: A prospective Randomized Study

“…Postoperative analgesic efficacy and supplementary analgesic needs of penile block and caudal block were found to be similar in the prospective randomized study of Beyaz et al (8).…”

Dorsal penile nerve block for circumcision in pediatric patients: A prospective, observer‐blinded, randomized controlled clinical trial for the comparison of ultrasound‐guided vs landmark technique

“…2,3 Several regional anesthesia techniques have been described for providing effective postoperative analgesia, including caudal block, ring block of the penis, and the dorsal penile nerve block (DPNB). 4 DPNB has been proven to be an effective, easy, and safe technique. 5,6 Traditionally, the DPNB has been performed using a landmark-based technique.…”

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

“…Dorsal penaile nerve block and caudal block provided similar postoperative analgesic effects without major complications for children under general anaesthesia. [19] Caudal anaesthesia is established to be safe in children, because the procedure is technically simple to perform, the success rate is high and complications are rare.…”