Penile block for paediatric urological surgery: A comparative evaluation with general anaesthesia

Panda, Aparajita; Bajwa, Sukhminder Jit Singh; Sen, Subroto; Parmar, SS

doi:10.4103/0970-1591.91432

Cited by 9 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More recently, Baird reviewed analgesic methods for pediatric hernia repair; there too, similar to our findings, they found no difference in analgesic outcome between caudal and peripheral blocks by 1 h after surgery ( 6 ). Contrary to our finding, Panda showed more effective analgesia up to 8 h after penile surgery with a DPNB and earlier recovery of normal eating compared to general anesthesia with fentanyl ( 7 ). A retrospective analysis of caudal vs. penile blocks with and without ultrasound guidance for circumcisions found that fewest caudal patients required intra-operative narcotics and that they had the longest time before requesting supplemental analgesia; the ultrasound guided block was as effective as the caudal in the PACU, but the landmark penile blocks required significantly more narcotics peri-operatively.…”

Section: Discussioncontrasting

confidence: 99%

Comparison of Caudal Block vs. Penile Block vs. Intravenous Fentanyl Only in Children Undergoing Penile Surgery: A Prospective, Randomized, Double Blind Study

et al. 2021

View full text Add to dashboard Cite

Objectives: Penile surgery is commonly performed in pediatric surgical centers. There is no consensus regarding which analgesic method is most effective in controlling pain in these children.Methods: Consecutive children between 4 months and 16 years of age who underwent elective penile surgery were recruited. After inhaled induction of anesthesia, children were randomized to one of three methods of intraoperative analgesia: caudal block, IV fentanyl titrated to surgical response and spontaneous respiration, or dorsal penile nerve block (DPNB). All patients were given inhaled agents; fentanyl was added if either block was insufficient. Demographic data, analgesic use and pain scores were recorded by a blinded investigator in the PACU and ward. Pain scores, analgesic requirement, and recovery parameters of returning to normal activity level, eating, and voiding post-operatively for up to 4 days, were compared.Results: 116 children were recruited. Pain scores in the post anesthesia care unit were significantly lower in the DPNB and caudal block groups compared to the fentanyl group for the first 30 postoperative min. Pain scores and analgesic use were subsequently similar among the three groups for the rest of the study period. There was no statistical difference in time to eat, return to normal activity or in parental satisfaction scores among the groups. There was a trend toward earliest time to void in the DPNB group.Conclusions: Regional blocks most effectively controlled pain for 30 min after surgery. The choice of intra-operative analgesia protocol had no effect on later pain and recovery parameters.

show abstract

Section: Discussioncontrasting

confidence: 99%

Comparison of Caudal Block vs. Penile Block vs. Intravenous Fentanyl Only in Children Undergoing Penile Surgery: A Prospective, Randomized, Double Blind Study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…This result was in line with the findings of the Panda et al (11) investigation, which showed that Group GC took longer than the general anesthetic only group to request analgesia.…”

Section: Discussionsupporting

confidence: 90%

Caudal Block for Analgesia in Pediatrics Undergoing Hypospadias Repair Surgery under General Anesthesia

Alakhdary¹,

Alwakil²,

Zanfaly³

et al. 2023

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Background: The treatment of anesthetic patients increasingly includes postoperative pain management. Many methods of controlling juvenile pain have been devised, with caudal blocking being the most widely used.Objective: The aim of the current study was to evaluate the efficacy of pain management during and after hypospadias correction surgery in pediatric patients under general anesthesia alone and general anesthesia combined with caudal block. Patients and methods: A total of 42 pediatric patients scheduled for hypospadius repair surgery, were equally divided into two groups (21 in each); Group G received general anesthesia only and Group GC received general anesthesia combined with caudal block. Results: Group G had significantly higher dose of intraoperative fentanyl (16.09±1.99 microgram) versus (13.71±1.71microgram) in Group GC. Regarding the duration since the first analgesia request, it was significantly longer in Group GC (96±0.106 min) when compared to Group G (34.67±4.69). All cases of Group G needed analgesics while only (22.8%) of Group GC needed analgesics. Face, Legs, Activity, Cry, and Consolability scale (FLACC) score was significantly lower in Group GC from immediately postoperative until 8 hours compared to Group G. FLACC score was non-significantly lower in both groups of study 12 hours and 24 hours post-operative. Conclusion: General anesthesia combined with caudal block was safe and effective for post-operative pain control than general anesthesia only in pediatrics patients undergoing hypospadius repair surgery.

show abstract

“…Male circumcision is a commonly practiced surgical procedure in our country (Tunisia) and DPNB is the preferred method of regional analgesia for circumcision, with excellent safety [ 4 , 5 ]. Consequently, any intervention that would enhance the care of these patients would have a substantial impact.…”

Section: Discussionmentioning

confidence: 99%

The analgesic effect of clonidine as an adjuvant in dorsal penile nerve block

Jarraya¹,

Smaoui²,

Abidi³

et al. 2016

Pan Afr Med J

View full text Add to dashboard Cite

IntroductionDorsal penile nerve block (DPNB) is a commonly performed regional anesthetic technique for male circumcision. The aim of this study was to assess the analgesic effect of the adjunction of clonidine to bupivacaine 0.5% in this block.MethodsIt was a prospective randomized double-blind clinical trial including 40 ASA1 boys aged from 1 to 4 years undergoing elective circumcision. Dorsal penile nerve block was performed under general Anesthesia. Patients were randomized in two groups: Group 1 (G1): received 0.1 ml/Kg of bupivacaine 0.5% with 1µg/kg of clonidine in each side. Group 2 (G2): received 0.1 ml/kg of bupivacaine 0.5% with placebo in each side. The failure of the DNPB was defined by the increase of heart rate by more than 25% comparing to baseline and in his case an intravenous injection of 20 µg/kg of alfentanyl was given. Post-operative pain was assessed by CHEOPS score.ResultsA total of 40 patients were enrolled. Demographic parameters were similar in both groups. We noted no case of DNPB failure in this study. The supply for additional analgesia was seen in 12 patients in group 2 versus 3 cases in group 1. CHEOPS (Children's Hospital of Eastern Ontario Pain Scale) was significantly lower in group 1 from 2nd post operative hour until the 24th hour.ConclusionClonidine can be used in dorsal penile nerve block to improve and to prolong its analgesic effects after male circumcision.

show abstract

Penile block for paediatric urological surgery: A comparative evaluation with general anaesthesia

Cited by 9 publications

References 21 publications

Comparison of Caudal Block vs. Penile Block vs. Intravenous Fentanyl Only in Children Undergoing Penile Surgery: A Prospective, Randomized, Double Blind Study

Comparison of Caudal Block vs. Penile Block vs. Intravenous Fentanyl Only in Children Undergoing Penile Surgery: A Prospective, Randomized, Double Blind Study

Caudal Block for Analgesia in Pediatrics Undergoing Hypospadias Repair Surgery under General Anesthesia

The analgesic effect of clonidine as an adjuvant in dorsal penile nerve block

Contact Info

Product

Resources

About