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Topical application of local anesthetics for postoperative analgesia in children undergoing circumcision
C S Chen1, M C Tunng, C L Yang
1Department of Anaesthesiology, National Taipei College of Nursing, Taiwan, ROC.
Insights
Postoperative pain after circumcision can be effectively managed with topical prilocaine hydrochloride spray or dipucaine ointment. Both treatments provided adequate pain relief and were well-tolerated by pediatric patients.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Pain Management
Background:
- Post-circumcision pain is a common postoperative concern in pediatric patients.
- Effective pain management strategies are crucial for patient recovery and well-being.
Purpose of the Study:
- To compare the efficacy and safety of topical prilocaine hydrochloride spray versus dipucaine ointment for post-circumcision analgesia.
- To evaluate pain levels and complications in pediatric patients receiving either treatment.
Main Methods:
- A randomized study involving forty boys undergoing day case circumcision.
- Application of either 4% prilocaine hydrochloride spray or 1.1% dipucaine ointment post-operation.
- Analgesia assessment using a three-point scale, parental questionnaires, and activity level evaluation.
Main Results:
- Both topical prilocaine hydrochloride and dipucaine provided satisfactory postoperative analgesia.
- No significant complications were reported, with only one instance of vomiting in the dipucaine group.
- Topical analgesics simplified pain management and were well-received by patients and parents.
Conclusions:
- Topical prilocaine hydrochloride and dipucaine are safe and effective options for managing post-circumcision pain.
- These topical agents offer a simple and adequate solution for pediatric post-circumcision pain relief.
Abstract:
Circumcision often followed by severe pain during the postoperative period. Forty boys, ASA class I, presenting for day case circumcision were allocated randomly to receive either 4% prilocaine hydrochloride spray or 1.1% dipucaine ointment at the end of the operation. Analgesia was assessed by a single observer utilizing a three-point scale in recovery room. The parents were asked to complete the questionnaire 8h following operation and on the morning of the first postoperative day. At approximately 24h following operation an assessment of the child's activity level was made by the parents. The frequency of taking the oral analgesia was also recorded. Both topical analgesics provided satisfied analgesia during the postoperative period and no complication was noted. Only one patient in dipucaine group vomited in the recovery room. We conclude that topical use of prilocaine hydrochloride and dipucaine can provide a simple, safe and adequate analgesia for post-circumcision pain relief.