본문 바로가기
KERD
논문KCI 등재

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

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

초록

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.

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.

참고문헌 (20)

  1. Choi WY, "EMLA cream versus dorsal penile nerve block for postcircumcision analgesia in children", Anesth Analg, 96, pp.396~399 (2003)
  2. Serour F, "Dorsal penile nerve block in children undergoing circumcision in a day-care surgery", Can J Anaesth, 43, pp.954~958 (1996)
  3. Telgarsky B, "Penile block in children, our first experience", Bratisl Lek Listy, 107, pp.320~322 (2006)
  4. Ivani G, "Pediatric regional anesthesia", Minerva Anestesiol, 75, pp.577~583 (2009)
  5. Silvani P, "Caudal anesthesia in pediatrics: an update", Minerva Anestesiol, 72, pp.453~459 (2006)
  6. Brady-Fryer B, "Pain relief for neonatal circumcision", Cochrane Database Syst Rev, 18, pp.CD004217~ (2004)
  7. De Negri P, "New drugs, new techniques, new indications in pediatric regional anesthesia", Minerva Anestesiol, 68, pp.420~427 (2002)
  8. Cyna AM, "Caudal epidural block versus other methods of postoperative pain relief for circumcision in boys", Cochrane Database Syst Rev, 8, pp.CD003005~ (2008)
  9. Uguralp S, "Regional anesthesia is a good alternative to general anesthesia in pediatric surgery: Experience in 1,554 children", J Pediatr Surg, 37, pp.610~613 (2002)
  10. Voepel-Lewis T, "A comparison of the clinical utility of pain assessment tools for children with cognitive impairment", Anesth Analg, 106, pp.72~78 (2008)
  11. Ramsay MA, "Controlled sedation with alphaxalone-alphadolone", Br Med J, 2, pp.656~659 (1974)
  12. Humphries Y, "Superiority of oral ketamine as an analgesic and sedative for wound care procedures in the pediatric patient with burns", J Burn Care Rehabil, 18, pp.34~36 (1997)
  13. Metzelder ML, "Penile block is associated with less urinary retention than caudal anesthesia in distal hypospadia repair in children", World J Urol, 28, pp.87~91 (2010)
  14. Sanford M, "Levobupivacaine: a review of its use in regional anaesthesia and pain management", Drugs, 70, pp.761~791 (2010)
  15. Frawley GP, "Levobupivacaine caudal anesthesia in children: a randomized double-blind comparison with bupivacaine", Paediatr Anaesth, 16, pp.754~760 (2006)
  16. Weksler N, "Is penile block better than caudal epidural block for postcircumcision analgesia", J Anesth, 19, pp.36~39 (2005)
  17. Stolik-Dollberg OC, "Bupivacaine versus lidocaine analgesia for neonatal circumcision", BMC Pediatr, 5, pp.12~ (2005)
  18. Margetts L, "A comparison of caudal bupivacaine and ketamine with penile block for paediatric circumcision", Eur J Anaesthesiol, 25, pp.1009~1013 (2008)
  19. Sandeman DJ, "A retrospective audit of three different regional anaesthetic techniques for circumcision in children", Anaesth Intensive Care, 38, pp.519~524 (2010)
  20. Faraoni D, "Does ultrasound guidance improve the efficacy of dorsal penile nerve block in children", Paediatr Anaesth, 20, pp.931~936 (2010)

관련 논문AI추천

Predictive Factors of Postoperative Pain and Postoperative Anxiety in Children Undergoing Elective Circumcision: A Prospective Cohort StudyEfstratios Christianakis, Emmanuel Pikoulis, Ioannis Yiannopoulos, Nick Zavras, Stella Tsamoudaki, Vasileia Ntomi대한통증학회 · The Korean Journal of Pain2015 · 제28권 제4호Postoperative analgesic effects of the quadratus lumborum block in pediatric patients: a systematic review and meta-analysis오아영, Bon-Wook Koo, Hyo-Seok Na, Hyun-Jung Shin, Insun Park, Jae Hyon Park, Jung-Hee Ryu대한통증학회 · The Korean Journal of Pain2024 · 제37권 제1호Comparison of Dexmedetomidine and Fentanyl as an Adjuvant to Ropivacaine for Postoperative Epidural Analgesia in Pediatric Orthopedic Surgery김승현, 김신형, 김현우, 도해윤, 박상준, 신서경, 최용선연세대학교의과대학 · Yonsei Medical Journal2017 · 제58권 제3호유 소아 서혜부 수술을 위한 미추마취박대팔, 이경숙영남대학교 의과대학 · Journal of Yeungnam Medical Science1990 · 제7권 제1호The impact of caudally administrated tramadol on immune response and analgesic efficacy for pediatric patients:a comparative randomized clinical trialAmal Ahmed Mahmoud, Emad Zareif Kamel, Ghada Shalaby Khalaf, Jehan Ahmed Sayed, Mohamed Amir Fathy Riad, Sayed Kaoud Abd Elshafy대한통증학회 · The Korean Journal of Pain2018 · 제31권 제3호Dexmedetomidine during suprazygomatic maxillary nerve block for pediatric cleft palate repair, randomized double-blind controlled studyAhmed K. Ibrahim, Fatma A. Abdel Aal, Ibrahim Hassan Ali, Mohamed F. Mostafa, Ragaa Herdan대한통증학회 · The Korean Journal of Pain2020 · 제33권 제1호

이 간행물의 다른 논문 (9건)