Çömez Mehmet Selim, Aydın Pelin
Department of Anesthesiology and Reanimation, Hatay Mustafa Kemal University Tayfur Ata Sökmen School of Medicine, Hatay, Turkey.
Department of Anesthesiology and Reanimation, Health Sciences University, Region Training and Research Hospital, Erzurum, Turkey.
Eurasian J Med. 2022 Feb;54(1):4-7. doi: 10.5152/eurasianjmed.2022.20402.
Postcircumcision pain in children can cause restlessness, crying and bleeding due to trauma. However, there are various methods to prevent postoperative pain, caudal and penile blocks are in the foreground. The primary objective of this study is to evaluate the effectiveness of CB and PB for the relief of postcircumcision pain. The secondary aim is to evaluate the postoperative additional analgesic requirement and side effects of these blocks.
A total of 148 children between the ages of 2 and 10 who underwent circumcision surgery were randomly assigned to two groups in terms of postoperative analgesia. 1) A group of caudal block (0,5 ml/kg %0.25 levobupivacaine) and 2) A group of penile block (0,3 ml/kg %0,25 levobupivacaine). Premedication and sedoanalgesia were standardized. The pain (FLACC Pain Score), analgesic consumption, motor block (Bromage Scale) and side effects (vomiting, hematoma, urinary retention) were assessed postoperatively for 4 hours.
Postoperative FLACC scores were lower for caudale block group in the 1st, 3rd and 4th hours. There was no significant difference in postoperative analgesic consumption between the groups. The most common postoperative side effect was vomiting in both groups.
Caudal block provided more effective analgesia than penile block in postcircumcision pain control.
儿童包皮环切术后疼痛可因创伤导致烦躁、哭闹和出血。然而，有多种方法可预防术后疼痛，其中骶管阻滞和阴茎阻滞最为常用。本研究的主要目的是评估骶管阻滞（CB）和阴茎阻滞（PB）缓解包皮环切术后疼痛的有效性。次要目的是评估这些阻滞术后的额外镇痛需求和副作用。
总共148例年龄在2至10岁之间接受包皮环切手术的儿童，根据术后镇痛随机分为两组。1）骶管阻滞组（0.5 ml/kg 0.25%左旋布比卡因）和2）阴茎阻滞组（0.3 ml/kg 0.25%左旋布比卡因）。术前用药和镇静镇痛均标准化。术后4小时评估疼痛（FLACC疼痛评分）、镇痛药物消耗量、运动阻滞（布罗麻量表）和副作用（呕吐、血肿、尿潴留）。
骶管阻滞组术后第1、3和4小时的FLACC评分较低。两组术后镇痛药物消耗量无显著差异。两组最常见的术后副作用均为呕吐。
在包皮环切术后疼痛控制方面，骶管阻滞比阴茎阻滞提供更有效的镇痛。
