Departmant of Anesthesia and Reanimation, Sevgi Women's and Children's Hospital, Ordu, Turkey.
Korean J Pain. 2011 Mar;24(1):31-5. doi: 10.3344/kjp.2011.24.1.31. Epub 2011 Feb 25.
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.
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.
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.
DPNB and caudal block provided similar postoperative analgesic effects without major complications for children under general anesthesia.
包皮环切术是小儿外科中一种常见的有创操作。本研究旨在比较全身麻醉下骶管阻滞与阴茎背神经阻滞（DPNB）用于小儿包皮环切术的效果。
本研究于 2009 年 7 月 1 日至 2009 年 10 月 16 日进行。选择 ASA 分级Ⅰ级的 50 例行包皮环切术的男性患儿，年龄 3~12 岁，采用随机、前瞻性、对照研究。所有患儿均采用标准化的麻醉技术。患儿随机分为 2 组，1 组行 DPNB（0.25%0.5 ml/kg 左旋布比卡因），2 组行骶管阻滞。术后 6 小时采用 Flacc 疼痛评分法（5 个等级：F 面部、L 腿部、A 活动、C 哭闹、C 安慰）评估术后镇痛效果。记录每个患儿的追加镇痛药物的剂量、次数以及可能出现的局部或全身并发症。
2 组患儿的年龄、体质量、麻醉时间、FLACC 疼痛评分和镇静评分无统计学差异（P > 0.05）。然而，在随后的测量中，DPNB 组和骶管阻滞组的疼痛和镇静评分均显著下降（P < 0.001）。2 种技术均未出现严重并发症。
全身麻醉下，DPNB 和骶管阻滞均能提供相似的术后镇痛效果，且无严重并发症。
