Korean J Pain.  2011 Mar;24(1):31-35. 10.3344/kjp.2011.24.1.31.

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

• Beyaz SG

• KMID: 2278094
• DOI: http://doi.org/10.3344/kjp.2011.24.1.31

Abstract

BACKGROUND
Circumcision 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.
METHODS
This 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.
RESULTS
No 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.
CONCLUSIONS
DPNB and caudal block provided similar postoperative analgesic effects without major complications for children under general anesthesia.

Keyword

analgesic; caudal block; circumcision; dorsal penile nerve block; levobupivacaine

MeSH Terms

Aged
Analgesia
Anesthesia
Anesthesia, General
Body Weight
Bupivacaine
Child
Circumcision, Male
Female
Humans
Leg
Male
Prospective Studies
Pudendal Nerve
Bupivacaine

Figure

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  Fig. 1 Comparison of FLACC pain scores at different time intervals of Group 1 and Group 2. No significant difference was found between the groups. Group 1: DPNB group, Group 2: caudal block group. Data are expressed as mean ± SD.

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  Fig. 2 Intergroup comparison of postoperative Ramsey sedation scores. Ramsey sedation scores versus time revealed that sedation scores decreased significantly over time (P < 0.001), but there was no significance difference between groups. Group 1: DPNB group, Group 2: caudal block group. Data are expressed as mean ± SD.

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