Regional Anesthesia in Circumcision Surgery: Which of the Two Things 
Is Better?

COMEZ, MEHMET; Aydın, Pelin

doi:10.5152/eurasianjmed.2022.20402

Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?

Mehmet Selim ÇÖMEZ, (Hatay Mustafa Kemal Üniversitesi, Tayfur Ata Sökmen Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Hatay, Türkiye)

Pelin AYDIN (Sağlık Bilimleri Üniversitesi, Bölge Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Erzurum, Türkiye)

Eurasian Journal of Medicine

1 0

Yıl: 2022 Cilt: 54 Sayı: 1 Sayfa Aralığı: 4 - 7 Metin Dili: İngilizce DOI: 10.5152/eurasianjmed.2022.20402 İndeks Tarihi: 24-06-2022

Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?

Öz:

Objective: Postcircumcision pain in children can cause restlessness, crying and bleeding due to trauma. However, there are various methods to prevent postoperative pain, caudal and penile blocks are in the foreground. The primary objective of this study is to evaluate the effectiveness of CB and PB for the relief of postcircumcision pain. The secondary aim is to evaluate the postoperative additional analgesic requirement and side effects of these blocks. Materials and Methods: A total of 148 children between the ages of 2 and 10 who underwent circumcision surgery were randomly assigned to two groups in terms of postoperative analgesia. 1) A group of caudal block (0,5 ml/kg %0.25 levobupivacaine) and 2) A group of penile block (0,3 ml/kg %0,25 levobupivacaine). Premedication and sedoanalgesia were standardized. The pain (FLACC Pain Score), analgesic consumption, motor block (Bromage Scale) and side effects (vomiting, hematoma, urinary retention) were assessed postoperatively for 4 hours. Results: Postoperative FLACC scores were lower for caudale block group in the 1st, 3rd and 4th hours. There was no significant difference in postoperative analgesic consumption between the groups. The most common postoperative side effect was vomiting in both groups. Conclusion: Caudal block provided more effective analgesia than penile block in postcircumcision pain control.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. American Academy of Pediatrics Task Force on Circumcision. Male circumcision. Pediatrics. 2012;130(3):e756-e785. [CrossRef]
2. American Pain Society Task Force on Pain in InfantsChildren, Adolescents. The assessment and management of acute pain in infants, children, and adolescents. Pediatrics-Springfield. 2001;108(3):793-797.
3. Lunn JN. Postoperative analgesia after circumcision. A randomized comparison between caudal analgesia and intramuscular morphine in boys. Anaesthesia. 1979;34(6):552-554. [CrossRef]
4. Telgarsky B, Karovic D, Wassermann O, et al. Penile block in children, our first experience. Bratisl Lek Listy. 2006;107(8):320-322.
5. Brennan LJ. Modern day-case anaesthesia for children. Br J Anaesth. 1999;83(1):91-103. [CrossRef]
6. Semsroth M, Gabriel A, Sauberer A, Wuppinger G. Regional anesthetic procedures in pediatric anesthesia. Anaesthesist. 1994;43(1):55- 72. [CrossRef]
7. Silvani P, Camporesi A, Agostino MR, Salvo I. Caudal anesthesia in pediatrics: an update. Minerva Anestesiol. 2006;72(6):453-459.
8. Tsui BC, Suresh S. Pediatric Atlas of UltrasoundAnd Nerve Stimulation-Guided Regional Anesthesia. Springer; Berlin; 2015.
9. Hadzic A. Hadzic's Textbook of Regional Anesthesia and Acute Pain Management. McGraw-Hill Education New York; 2017.
10. Holder KJ, Peutrell JM, Weir PM. Regional anaesthesia for circumcision. Subcutaneous ring block of the penis and subpubic penile block compared. Eur J Anaesthesiol. 1997;14(5):495-498. [CrossRef]
11. Irwin MG, Cheng W. Comparison of subcutaneous ring block of the penis with caudal epidural block for post-circumcision analgesia in children. Anaesth Intensive Care. 1996;24(3):365-367. [CrossRef]
12. Canakci E, Yagan O, Tas N, Mutlu T, Cirakoglu A, Benli E. Comparison of preventive analgesia techniques in circumcision cases: dorsal penile nerve block, caudal block, or subcutaneous morphine? J Pak Med Assoc. 2017;67(2):159-165.
13. Seyedhejazi M, Azerfarin R, Kazemi F, Amiri M. Comparing caudal and penile nerve blockade using bupivacaine in hypospadias repair surgeries in children. Afr J Paediatr Surg. 2011;8(3):294-297. [CrossRef]
14. Chhibber AK, Perkins FM, Rabinowitz R, Vogt AW, Hulbert WC. Penile block timing for postoperative analgesia of hypospadias repair in children. J Urol. 1997;158(3 Pt 2):1156-1159. [CrossRef]
15. Chan KH, Shah A, Moser EA, et al. Comparison of intraoperative and early postoperative outcomes of caudal vs dorsal penile nerve blocks for outpatient penile surgeries. Urology. 2018;118:164-171. [CrossRef]
16. Malik K, Chamberlain RS. Caudal and penile blocks demonstrate similar reliability and efficacy in pediatric patients undergoing circumcision: a meta-analysis. Int J Clin Med. 2016;07(5):309-319. [CrossRef]
17. Demiraran Y, Akman Y, Tuce Z, Cam K, Erol A. A comparison of postoperative analgesic efficacy of dorsal penile nerve block versus single dose caudal epidural block for penile surgery in children. Med J Kocatepe. 2005;6:47-52.
18. Athar M, Ahmed SM, Ali S, Siddiqi OA. Levobupivacaine: a safer alternative. J Curr Res Sci Med. 2016;2(1):3. [CrossRef]
19. Beyaz SG. Comparison of postoperative analgesic efficacy of caudal block versus dorsal penile nerve block with levobupivacaine for circumcision in children. Korean J Pain. 2011;24(1):31-35. [CrossRef]
20. Ozen V, Yigit D. A comparison of the postoperative analgesic effectiveness of low dose caudal epidural block and US-guided dorsal penile nerve block with in-plane technique in circumcision. J Pediatr Urol. 2020;16(1):99-106. [CrossRef]
21. Wang X, Dong C, Beekoo D, et al. Dorsal penile nerve block via perineal approach, an alternative to a caudal block for pediatric circumcision: a randomized controlled trial. BioMed Res Int. 2019;2019:6875756. [CrossRef]
22. Lönnqvist PA. Regional anaesthesia and analgesia in the neonate. Best Pract Res Clin Anaesthesiol. 2010;24(3):309-321. [CrossRef]
23. Yang CC, BRADLEY WE. Innervation of the human glans penis. J Urol. 1999;161(1):97-102. [CrossRef]
24. Bosenberg A. Regional anaesthesia in children: an update. South Afr J Anaesth Analg. 2013;19(6):282-288. [CrossRef]
25. Serour F, Reuben S, Ezra S, Greenfield SP. Circumcision in children with penile block alone. J Urol. 1995;153(2):474-476. [CrossRef]
26. Sara CA, Lowry CJ. A complication of circumcision and dorsal nerve block of the penis. Anaesth Intensive Care. 1985;13(1):79-82. [CrossRef]
27. Burke D, Joypaul V, Thomson MF. Circumcision supplemented by dorsal penile nerve block with 0.75% ropivacaine: a complication. Reg Anesth Pain Med. 2000;25(4):424-427. [CrossRef]

APA	COMEZ M, Aydın P (2022). Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?. , 4 - 7. 10.5152/eurasianjmed.2022.20402
Chicago	COMEZ MEHMET,Aydın Pelin Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?. (2022): 4 - 7. 10.5152/eurasianjmed.2022.20402
MLA	COMEZ MEHMET,Aydın Pelin Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?. , 2022, ss.4 - 7. 10.5152/eurasianjmed.2022.20402
AMA	COMEZ M,Aydın P Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?. . 2022; 4 - 7. 10.5152/eurasianjmed.2022.20402
Vancouver	COMEZ M,Aydın P Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?. . 2022; 4 - 7. 10.5152/eurasianjmed.2022.20402
IEEE	COMEZ M,Aydın P "Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?." , ss.4 - 7, 2022. 10.5152/eurasianjmed.2022.20402
ISNAD	COMEZ, MEHMET - Aydın, Pelin. "Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?". (2022), 4-7. https://doi.org/10.5152/eurasianjmed.2022.20402

APA	COMEZ M, Aydın P (2022). Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?. Eurasian Journal of Medicine, 54(1), 4 - 7. 10.5152/eurasianjmed.2022.20402
Chicago	COMEZ MEHMET,Aydın Pelin Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?. Eurasian Journal of Medicine 54, no.1 (2022): 4 - 7. 10.5152/eurasianjmed.2022.20402
MLA	COMEZ MEHMET,Aydın Pelin Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?. Eurasian Journal of Medicine, vol.54, no.1, 2022, ss.4 - 7. 10.5152/eurasianjmed.2022.20402
AMA	COMEZ M,Aydın P Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?. Eurasian Journal of Medicine. 2022; 54(1): 4 - 7. 10.5152/eurasianjmed.2022.20402
Vancouver	COMEZ M,Aydın P Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?. Eurasian Journal of Medicine. 2022; 54(1): 4 - 7. 10.5152/eurasianjmed.2022.20402
IEEE	COMEZ M,Aydın P "Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?." Eurasian Journal of Medicine, 54, ss.4 - 7, 2022. 10.5152/eurasianjmed.2022.20402
ISNAD	COMEZ, MEHMET - Aydın, Pelin. "Regional Anesthesia in Circumcision Surgery: Which of the Two Things Is Better?". Eurasian Journal of Medicine 54/1 (2022), 4-7. https://doi.org/10.5152/eurasianjmed.2022.20402