Related Experiment Videos

Addition of clonidine and fentanyl: comparison between three different regional anesthetic techniques in circumcision

Zouher A Naja1, Fouad M Ziade, Mohamad A Al-Tannir

  • 1Department of Anaesthesia and Pain Medicine, Makassed General Hospital, Beirut, Lebanon. zouhnaja@yahoo.com

Paediatric Anaesthesia
|October 22, 2005
PubMed

Insights

The combined dorsal penile block and ring block (RB) technique effectively reduces post-circumcision pain in children. This method is superior to using either the dorsal penile block or RB alone for pain management.

Area of Science:

  • Pediatric Anesthesiology
  • Surgical Pain Management

Background:

  • Regional anesthesia is more effective than systemic opioids for post-circumcision pain.
  • Various regional anesthetic techniques exist for pain relief.

Purpose of the Study:

  • To compare the efficacy of dorsal penile block (DPB), ring block (RB), and a combination of DPB and RB in alleviating post-circumcision pain in children.

Main Methods:

  • A prospective, randomized, double-blind clinical trial involving 100 boys aged 1-5 years undergoing circumcision.
  • Participants received one of three anesthetic techniques: RB, DPB, or combined DPB + RB, using a mixture of lidocaine, bupivacaine, fentanyl, and clonidine.

Main Results:

  • The combined DPB + RB group showed significantly lower pain scores on the first postoperative day compared to RB alone.
  • Children receiving RB or DPB alone consumed more analgesics in the first six postoperative hours.
  • Surgeon satisfaction was highest (100%) in the combined DPB + RB group.

Conclusions:

  • The combination of dorsal penile block and ring block is the most effective technique for reducing post-circumcision pain in pediatric patients.
  • This combined approach offers superior pain relief compared to either technique used in isolation.
Abstract

Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...