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

Frontiers in Pediatrics

article

Margaret Ekstein¹  Avi A. Weinbroum¹  Jacob Ben-Chaim²  Eyal Amar³  Reut Schvartz¹  Yifat Klein¹  Yuval Bar-Yosef² 

[1] Department of Anesthesiology & Critical Care & Pain, Tel Aviv University;Department of Pediatric Urology, Tel Aviv University;Department of Orthopedics, Tel-Aviv Medical Center Affiliated With Sackler Medical School, Tel Aviv University

关键词: anesthesia;    penis (MeSH);    pediatrics;    children;    surgery;    pain;   

DOI  :  10.3389/fped.2021.654015

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

CC BY