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

Haliloğlu, Ahmet Hakan; Gökçe, Mehmet İlker; Tangal, Semih; Boğa, Mehmet; Tapar, Hakan; Aladag, Ebru

doi:10.1590/s1677-5538.ibju.2013.04.13

Cited by 13 publications

(13 citation statements)

References 12 publications

(8 reference statements)

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“…Thus, pain control was much better in group B neonates whereas neonates in group A experienced much pain immediately after the circumcision. These observations disagree with a previous study from Turkey where there was no significant difference in the mean pain scores after 1 h, although an intravenous acetaminophen injection was used and the cohort of patients studied was from 1 to 7 years [19]. The findings in this study may be related to the onset of action and duration of action as well as the route of administration of these agents.…”

Section: Discussioncontrasting

confidence: 99%

Comparing pain control using oral acetaminophen versus dorsal penile block in neonatal circumcision

et al. 2019

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Background: Circumcision is one of the commonest surgical procedures performed yet the most controversial worldwide. Although various reasons have been suggested in support of circumcision, the pain and stress that accompany it on both neonates and mothers are factors against the procedure. This study compared pain control using oral acetaminophen syrup versus 1% lidocaine injection given as dorsal penile block during neonatal circumcision. Results: There were 191 neonates in group A and 195 in group B. The mean age at circumcision was 23.71 (SD ± 20.39) days, and mean weight was 3.33 (SD ± 0.74) kg. The mean pain scores for group A immediately and 1 h after circumcision were 4.26 (SD ± 2.48) and 0.37 (SD ± 1.35), respectively. In group B, the mean pain scores immediately and 1 h after circumcision were 3.31 (SD ± 2.59) and 0.35 (SD ± 1.19), respectively. Conclusion: Penile block gives better pain control in comparison with oral acetaminophen syrup, but both agents are effective and can be combined to provide a long-lasting perioperative anaesthesia and analgesia for circumcision in the hospital setting.

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Section: Discussioncontrasting

confidence: 99%

Comparing pain control using oral acetaminophen versus dorsal penile block in neonatal circumcision

et al. 2019

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“…These results are consistent with a prior Cochrane systematic review (2008) involving 4 RCTs (N = 336), as the study also failed to reveal any difference in the efficacy or need for rescue analgesia between CB and PB (RR = 1.25, 95% CI = 0.64 to 2.44, p = 0.52) [22]. A RCT of 104 patients by Haliloglu et al (2013) reported a higherpain score in children postoperatively following PB at 30 minutes but not at 60 minutes (30 minutes: p < 0.001 and at 60 minutes: p = 0.189) [1]. These results suggest any difference in analgesia after PB and CB wanes quickly after the first half hour of administration.…”

Section: Discussionsupporting

confidence: 89%

“…Male circumcision is the most common pediatric surgical procedure performed globally [1] [2]. Worldwide regional prevalence varies significantly due to social, cultural, and religious influences [3].…”

Section: Introductionmentioning

confidence: 99%

Caudal and Penile Blocks Demonstrate Similar Reliability and Efficacy in Pediatric Patients Undergoing Circumcision: A Meta-Analysis

Malik¹,

Chamberlain²

2016

IJCM

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Purpose: Circumcision is one of the most common surgeries performed in the pediatric population. Multiple regional analgesic techniques, including caudal (CB) and penile block (PB), have championed as offering optimal analgesia for circumcision in the post-neonatal pediatric population without clear consensus. This meta-analysis sought to investigate CB and PB's analgesic efficacy and the impact on postoperative analgesic requirements in pediatric circumcisions. Methods: A comprehensive literature search of PubMed, Google Scholar, and Cochrane Library (1966-2016) was completed to identify all published randomized control trials (RCTs). Keywords searched included "circumcision", "caudal block", "penile block", and "analgesia". Inclusion criteria were limited to the comparison of PB versus CB in children less than 18 years of age and its efficacy towards circumcision. The efficacy, time to first additive analgesia, time to first micturition, duration of prolonged motor blockade, incidence of vomiting, and length of stay were analyzed. Results: 9 RCTs involving 574 children (N = 287 in CB and PB) were included. No differences in analgesic efficacy (relative risk (RR) = 0.983, 95% confidence interval (CI) = 0.95 to 1.02; p = 0.328) or time to first additive analgesia were observed (standardized difference in mean (SDM) = 0.438, 95% CI = −0.04 to 0.92; p = 0.073). Time to first micturition (SDM = 0.680, 95% CI = 0.40 to 0.96; p < 0.001) and motor block duration (SDM = 0.707, 95% CI = 0.19 to 1.22; p = 0.007) were significantly prolonged in patients receiving CB. No differences were observed between groups in regards to the incidence of vomiting (RR = 1.56, 95% CI = 0.91 to 2.67; p = 0.107) and length of stay (SDM = 0.741, 95% CI = −0.05 to 1.53; p = 0.066). Conclusion: CB and PB offer similar analgesic success rates for pediatric patients (age 18 months to 16 years) undergoing circumcision. CB is associated with a * Corresponding author. K. Malik, R. S. Chamberlain 310 trend towards longer duration of analgesia, but is associated with prolonged urinary retention and delayed ambulation. CB use is recommended in non-ambulatory children, whereas PB is recommended in ambulatory children.

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“…[12] To our knowledge, there are few studies comparing validated pain scale scores and only one prior study comparing procedural time. [12][13][14][15] In addition, prior studies comparing analgesic efficacy consist of small retrospective case series. [12][13][14][15][16][17][18][19][20] The purpose of this study was to compare intraoperative and 1-hour postoperative outcomes of caudal blocks vs. DPNBs in pediatric patients undergoing outpatient penile surgeries.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Intraoperative and Early Postoperative Outcomes of Caudal vs Dorsal Penile Nerve Blocks for Outpatient Penile Surgeries

Chan

Shah

Moser

et al. 2018

Urology

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

Abstract: Purpose: To evaluate the postoperative analgesic efficacy of penile block, caudal block and intravenous paracetamol administration following circumcision. Materials and Methods:In this prospective randomized study a total of 159 patients underwent circumcision under general anesthesia at

Cited by 13 publications

References 12 publications

Comparing pain control using oral acetaminophen versus dorsal penile block in neonatal circumcision

Comparing pain control using oral acetaminophen versus dorsal penile block in neonatal circumcision

Caudal and Penile Blocks Demonstrate Similar Reliability and Efficacy in Pediatric Patients Undergoing Circumcision: A Meta-Analysis

Comparison of Intraoperative and Early Postoperative Outcomes of Caudal vs Dorsal Penile Nerve Blocks for Outpatient Penile Surgeries

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