Ozen Volkan
Department of Anesthesiology and Reanimation, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
Int J Clin Pract. 2021 Oct;75(10):e14366. doi: 10.1111/ijcp.14366. Epub 2021 Jul 13.
To compare the postoperative analgesic efficacy and postoperative complications of the pudendal nerve block (PNB) and caudal block (CB) with ultrasound (US).
A prospective observational study.
This study was included male patients aged between 4 and 12 years in the ASA I-II group and scheduled for circumcision. A low-dose CB or US-guided PNB was administered under general anaesthesia before the operation. Postoperative pain was evaluated using the Children's Hospital Eastern Ontario Pain Scale (CHEOPS) and Faces Pain Scale-Revised. Postoperative analgesic need was also noted.
The study was completed with a total of 100 patients consisting of 50 patients who received a CB and 50 who received a PNB. Intraoperative block failure was not seen in any patient. The mean CHEOPS score (P < .001) and the 6th (P = .003) and 12th hours (P < .001) CHEOPS scores were found to be statistically significantly higher in the CB group. There were no postoperative side effects in the PNB group with a statistically significant difference compared with the CB group (P = .027).
This first prospective study in the literature shows that US-guided PNB provided a more pronounced and longer analgesic effect and resulted in less requirement for postoperative analgesics than US-guided CB.
比较超声引导下阴部神经阻滞（PNB）和骶管阻滞（CB）的术后镇痛效果及术后并发症。
一项前瞻性观察研究。
本研究纳入年龄在4至12岁、ASA I-II级、计划行包皮环切术的男性患者。在手术前全身麻醉下给予低剂量CB或超声引导下PNB。使用东安大略儿童医院疼痛量表（CHEOPS）和面部疼痛量表修订版评估术后疼痛。记录术后镇痛需求。
本研究共纳入100例患者，其中50例接受CB，50例接受PNB。所有患者术中均未出现阻滞失败。CB组的平均CHEOPS评分（P <.001）以及第6小时（P =.003）和第12小时（P <.001）的CHEOPS评分在统计学上显著更高。PNB组无术后副作用，与CB组相比有统计学显著差异（P =.027）。
文献中的这项首次前瞻性研究表明，超声引导下PNB比超声引导下CB提供了更显著、更持久的镇痛效果，且术后镇痛需求更少。
