Department of Anesthesiology and Reanimation, Prof. Dr. Cemil TASCIOGLU City Hospital, Istanbul, Turkey.
Department of English Nursing, Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey.
Urol Int. 2023;107(4):370-376. doi: 10.1159/000521718. Epub 2022 Feb 10.
The primary aim of the study was to use the duration until the first postoperative analgesic requirement after two different block techniques to compare the analgesic effect. The secondary aims were to compare the two methods for postoperative Children's Hospital Eastern Ontario Pain Scale (CHEOPS) scores, complications, and parental satisfaction level.
This prospective, observational study was conducted with male patients aged 1-7 years in the ASA I-II group, who were scheduled for hypospadias surgery between November 2019 and April 2020. Ultrasound (US)-guided pudendal nerve block (PNB) or US-guided dorsal penile nerve block (DPNB) was administered under general anesthesia before the operation. Postoperative analgesic need, postoperative pain, complications, and parental satisfaction were noted. The STROBE checklist was followed for reporting.
The study was conducted with 30 patients in total, divided into 15 patients receiving PNB and 15 patients receiving DPNB. The effective minimum block duration was longer in the pudendal group at 22.22 ± 0.61 h than in the DPNB group at 22.19 ± 0.57 h. Additional analgesic was required in 4 subjects in the pudendal group and 5 in the DPNB group. There was no statistically significant difference in terms of the variables between the two groups (p > 0.05).
US-guided DPNB and PNB were shown to provide successful postoperative analgesia and to have similar effectiveness in pediatric patients undergoing hypospadias surgery in this first prospective study of its kind in the literature.
US-guided DPNB and PNB have been demonstrated to provide effective, safe, and long-term postoperative analgesia in pediatric patients who have undergone hypospadias surgery. Parental satisfaction in both groups is positively influenced by the minimum postoperative analgesia requirement, the long-term analgesic effect, and the lack of any complications.
本研究的主要目的是比较两种不同阻滞技术后首次术后镇痛需求的时间来评估镇痛效果。次要目的是比较两种方法的术后儿童安大略省东部医院疼痛量表（CHEOPS）评分、并发症和父母满意度。
这是一项前瞻性观察研究，纳入 2019 年 11 月至 2020 年 4 月间接受择期尿道下裂手术的 ASA I-II 级的 1-7 岁男性患儿。在全身麻醉前，超声（US）引导阴部神经阻滞（PNB）或 US 引导阴茎背神经阻滞（DPNB）。记录术后镇痛需求、术后疼痛、并发症和父母满意度。本研究遵循 STROBE 清单进行报告。
共有 30 例患儿纳入研究，分为 PNB 组（n=15）和 DPNB 组（n=15）。阴部神经阻滞组有效阻滞持续时间（22.22±0.61 h）长于阴茎背神经阻滞组（22.19±0.57 h）。阴部神经阻滞组 4 例患儿和阴茎背神经阻滞组 5 例患儿需要追加镇痛药物。两组间各变量无统计学差异（p>0.05）。
本首次前瞻性研究显示，在接受尿道下裂手术的儿童中，US 引导的 DPNB 和 PNB 均能提供成功的术后镇痛，且效果相似。
在接受尿道下裂手术的患儿中，US 引导的 DPNB 和 PNB 可提供有效、安全、长期的术后镇痛。两组患儿的父母均对最低术后镇痛需求、长期镇痛效果和无并发症的情况表示满意。
