Ramboatiana R, Gassner C, Schoch J P, Tartary D, Robert R, Tuefferd N, Vulliod D, Glele J, Houssier F
Département d'anesthésie-réanimation B. Centre hospitalier général André Boulloche-Montbéliard.
Agressologie. 1990 Jan;31(1):39-42.
Circumcision in children is followed by severe pain. This study analysed retrospectively anesthetic techniques of 110 children from 17 months to 14 years old who had undergone ambulatory of 24 h stay circumcision. There were two groups of patients: one being operated on under locoregional techniques combined with general anesthesia (53.6%), the other one under general anesthesia alone (46.4%). Post operative analgesia was provided by the regional anesthesia (with or without additional analgesics via rectal route) for the former group whereas analgesic drugs were administered only rectally for the latter one. In this second group, pain relief assessment was insufficiently recorded and was considered poor. In the first group, dorsal nerves block of the penis (DNBP) was performed on 47 children (79.8% of the locoregional techniques), caudal block on 10 patients and ring block on 2 patients. Regional techniques offered a satisfactory, safe and reliably effective post circumcision analgesia. DNBP should be used systematically in order to shorten duration of day circumcision stay.
儿童包皮环切术后会出现剧痛。本研究回顾性分析了110例17个月至14岁接受24小时门诊包皮环切术患儿的麻醉技术。患者分为两组：一组采用局部区域技术联合全身麻醉进行手术（53.6%），另一组仅采用全身麻醉（46.4%）。前一组术后镇痛采用区域麻醉（有或无经直肠途径额外使用镇痛药），而后一组仅经直肠给予镇痛药。在第二组中，疼痛缓解评估记录不足，被认为效果不佳。在第一组中，47例患儿（占局部区域技术的79.8%）进行了阴茎背神经阻滞（DNBP），10例患者进行了骶管阻滞，2例患者进行了环形阻滞。区域技术提供了令人满意、安全且可靠有效的包皮环切术后镇痛。应系统使用DNBP以缩短日间包皮环切术的住院时间。
