Szmuk P, Ezri T, Ben Hur H, Caspi B, Priscu L, Priscu V
Department of Anesthesiology, Kaplan Hospital, Rehovot, Israel.
Can J Anaesth. 1994 Dec;41(12):1181-4. doi: 10.1007/BF03020658.
Penile block (PB) in adults is not a well-recognized technique. The aim of this study was to compare, in a randomized prospective manner, five different techniques of PB in 250 adults undergoing circumcision with regard to anaesthetic quality, complications and postoperative analgesia. Patients were divided into five groups (50 per group) according to the technique used: Group A--"10, 30-13, 30" approach; Group B--the subpubic approach; Group C--subcutaneous ring block; Group D--a combination of frenulum infiltration and the "10, 30-13, 30" approach; Group E--a combination of frenulum infiltration and the subpubic approach. The number of failed blocks in Groups A and B (41 and 43 respectively) was greater than in Groups C, D and E (2, 3 and 5 respectively) (P < 0.001). The five groups did not differ with regard to adverse effects or time until the onset of postoperative pain when the blocks were successful. It is concluded that good surgical anaesthesia, a low rate of adverse effects and prolonged postoperative analgesia can be achieved by the use of either subcutaneous ring block or a combination of dorsal nerve block (using the "10, 30-13, 30" or the subpubic approach) and infiltration of the frenulum. These approaches to the PB are effective anaesthetic techniques for circumcision in adults.
成人阴茎阻滞（PB）并非一种广为人知的技术。本研究的目的是以随机前瞻性方式，比较250例接受包皮环切术的成人患者采用的五种不同阴茎阻滞技术在麻醉质量、并发症及术后镇痛方面的差异。根据所使用的技术，患者被分为五组（每组50例）：A组——“10点、30分至13点、30分”进针方法；B组——耻骨下进针方法；C组——皮下环行阻滞；D组——系带浸润联合“10点、30分至13点、30分”进针方法；E组——系带浸润联合耻骨下进针方法。A组和B组（分别为41例和43例）阻滞失败的例数多于C组、D组和E组（分别为2例、3例和5例）（P<0.001）。当阻滞成功时，五组在不良反应或术后疼痛开始时间方面无差异。得出的结论是，采用皮下环行阻滞或背神经阻滞（采用“10点、30分至13点、30分”或耻骨下进针方法）联合系带浸润，可实现良好的手术麻醉、低不良反应发生率及延长的术后镇痛。这些阴茎阻滞方法是成人包皮环切术有效的麻醉技术。
