Topical and systemic analgesia versus caudal epidural and dorsal penile nerve block in relieving pain after pediatric circumcision

Abstract

Objective: There is no consensus on the use of optimal analgesic method after pediatric circumcision, although, caudal block (CB), dorsal penile nerve block (DPNB), topical local anesthetic application and systemic analgesic administration are frequently used methods. In this study, we aimed to compare the postoperative analgesic effects and side effects, as well as parental satisfaction concerning these methods. Patients and Methods: Eighty children, aged 3-12 years, undergoing circumcision were randomized into four groups (n=20). Group Caudal Anesthesia (CA), Group Dorsal Penile Blok (DP), Group Topical Analgesia (TA), Group Systemic Analgesics (SA). The severity of pain was measured with NRS or CHEOPS scores. Time to awakening, first analgesic requirement, hospital discharge, side effects and parental satisfaction were recorded. Results: In groups CA and DP, pain scores during the first postoperative hour were lower than the pain scores of other groups and in group CA, the first analgesic requirement time was significantly longer compared to other groups (p<0.05). In the early postoperative hour, parental satisfaction was higher in group CA compared to other groups. Conclusion: In the early postoperative period, CB and DPNB reduce pain more effectively and provide more parental satisfaction than other applications, (in children who underwent) circumcision.