Satıcı Muhammed Halit, Tutar Mahmut Sami, Kozanhan Betül, Tire Yasin, Hanedan Bülent, Aksoy İlhami, Akkoyun İbrahim, Boleken Mehmet Emin, Altay Nuray
Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, 42020 Konya, Turkey.
Department of Pediatric Surgery, Konya City Hospital, University of Health Sciences, 42020 Konya, Turkey.
Healthcare (Basel). 2025 Mar 17;13(6):653. doi: 10.3390/healthcare13060653.
Circumcision is the most frequently performed surgery in male pediatric patients. The postoperative period is characterized by significant pain due to the sensitivity of the foreskin and low pain threshold in children. This study aimed to evaluate the effects of sacral erector spinae plane block (S-ESPB) and ring block on postoperative face, legs, activity, cry, and consolability (FLACC) pain scores after circumcision in children. We also assessed the amount of rescue analgesia used, the time to the first administration of rescue analgesia, potential problems, and parental satisfaction. This study was a prospective, randomized, multicenter trial conducted at two tertiary healthcare centers in Turkey. The patients were divided into two groups: Group S (patients who received the S-ESPB) and Group R (patients who received the ring block). The primary outcome measure was the FLACC score at 1 h postoperatively. Secondary outcome measures included FLACC scores at 0, 2, 4, and 6 h after surgery, the total dose of rescue analgesia, time to first rescue analgesia, complications, and parental satisfaction. Group S exhibited significantly lower FLACC scores than Group R at all time (0, 1, 2, 4, and 6 h) points (respectively, = 0.013, < 0.001, = 0.004, = 0.006, and = 0.002). Group S required significantly less rescue analgesia and exhibited a significantly longer duration of analgesic efficacy compared to Group R ( = 0.001 and = 0.002, respectively). The S-ESPB is a safe and effective form of analgesia for managing pain following pediatric circumcision surgery.
包皮环切术是男性儿科患者中最常施行的手术。由于包皮敏感且儿童疼痛阈值低，术后会出现明显疼痛。本研究旨在评估骶棘肌平面阻滞（S-ESPB）和环形阻滞对儿童包皮环切术后面部、腿部、活动、哭闹及安抚（FLACC）疼痛评分的影响。我们还评估了补救性镇痛药物的使用量、首次使用补救性镇痛药物的时间、潜在问题以及家长满意度。本研究是在土耳其的两家三级医疗中心进行的一项前瞻性、随机、多中心试验。患者被分为两组：S组（接受S-ESPB的患者）和R组（接受环形阻滞的患者）。主要观察指标为术后1小时的FLACC评分。次要观察指标包括术后0、2、4和6小时的FLACC评分、补救性镇痛药物的总剂量、首次使用补救性镇痛药物的时间、并发症及家长满意度。在所有时间点（0、1、2、4和6小时），S组的FLACC评分均显著低于R组（分别为P = 0.013、P < 0.001、P = 0.004、P = 0.006和P = 0.002）。与R组相比，S组所需的补救性镇痛药物显著更少，镇痛效果持续时间显著更长（分别为P = 0.001和P = 0.002）。S-ESPB是小儿包皮环切术后疼痛管理的一种安全有效的镇痛方式。
