Kazak Bengisun Züleyha, Ekmekci Perihan, Haliloğlu Ahmet Hakan
Department of Anesthesiology and Reanimation, Ufuk University, Faculty of Medicine, Ankara, Turkey.
Agri. 2012;24(4):180-6. doi: 10.5505/agri.2012.21931.
In this study, we evaluated the analgesic efficacy and adverse effect profile of levobupivacaine in caudal and DPNB in postcircumcision pediatric patients.
Sixty boys between 2-10 years of age undergoing circumcision were enrolled. The patients were divided into two groups: Group C (n=30) and Group P (n=30) were applied caudal block or dorsal penile nerve block (DPNB), respectively. Blocks were performed before surgery as a supplement to general anesthesia with 1 mL kg(-1) 0.25% levobupivacaine. Postoperative pain and sedation scores were assessed on the 10th and 30th minutes, and hours 1-6. The number of pain free patients in the first 6 hours, the duration of analgesia, time to first analgesic administration, walking, micturition, and total paracetamol demands, and length of stay were recorded.
Demographic data were similar between groups. The number of children who spent the first 6 hours pain-free was larger in Group C than Group P (p=0.0001). The time to first analgesic (p=0.000033) and walking (p=0.004) were longer in Group C. There were 14 patients with motor block in Group C (p=0.00007). In view of AUC, FPRS, OPS and MPOPS were significantly better in Group C on the first postoperative 6 hours.
Caudal block done using levobupivacaine for postoperative pain management in circumcision is more successful than penile block, however there is a significant delay in time to first walking and as might be expected there is an increased risk of motor block.
在本研究中，我们评估了左布比卡因用于小儿包皮环切术后骶管阻滞和阴茎背神经阻滞（DPNB）的镇痛效果及不良反应情况。
纳入60例年龄在2至10岁接受包皮环切术的男孩。患者分为两组：C组（n = 30）和P组（n = 30），分别接受骶管阻滞或阴茎背神经阻滞（DPNB）。在手术前进行阻滞，作为全身麻醉的补充，使用1 mL·kg⁻¹的0.25%左布比卡因。在术后第10分钟、30分钟以及1至6小时评估术后疼痛和镇静评分。记录前6小时无痛患者的数量、镇痛持续时间、首次给予镇痛药物的时间、行走时间、排尿时间、对乙酰氨基酚的总需求量以及住院时间。
两组间人口统计学数据相似。C组在前6小时无痛的儿童数量多于P组（p = 0.0001）。C组首次给予镇痛药物的时间（p = 0.000033）和行走时间（p = 0.004）更长。C组有14例患者出现运动阻滞（p = 0.00007）。鉴于曲线下面积（AUC），术后前6小时C组的FPRS、OPS和MPOPS明显更好。
使用左布比卡因进行骶管阻滞用于包皮环切术后疼痛管理比阴茎阻滞更成功，然而首次行走时间有显著延迟，并且正如预期的那样，运动阻滞风险增加。
