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Evaluation of the Postoperative Analgesic Effect of 2 Different Blocks after Pediatric Circumcision Surgery

Mehmet Mutlu1, Seray Turkmen1

  • 1Department of Anesthesiology and Reanimation, Prof. Dr. Cemil Tascıoglu City Hospital, İstanbul, Turkey.

Urologia Internationalis
|October 31, 2021
PubMed

Insights

The dorsal penile nerve (DPN) block offers superior, long-lasting pain relief after pediatric circumcision compared to the transversus abdominis plane (TAP) block. DPN block significantly reduced postoperative pain scores and the need for rescue analgesia.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Regional Anesthesia

Background:

  • Circumcision in male pediatrics is a painful procedure requiring effective anesthesia and analgesia.
  • Regional anesthesia techniques are commonly employed for pain management post-circumcision.

Purpose of the Study:

  • To compare the postoperative analgesic efficacy of dorsal penile nerve (DPN) block versus transversus abdominis plane (TAP) block in pediatric circumcision.
  • To evaluate complications associated with each block.

Main Methods:

  • Prospective observational study of 80 male children (under 10 years, ASA I-II) undergoing circumcision.
  • Ultrasound-guided TAP or DPN block performed after general anesthesia induction.
  • Postoperative pain assessed using Faces Pain Scale-Revised and the Faces, Legs, Activity, Cry and Consolability scale.

Main Results:

  • No significant difference in pain scores at 30 minutes post-surgery.
  • Significantly higher pain scores at 1, 2, 6, 12, and 24 hours in the TAP block group compared to the DPN block group.
  • First rescue analgesic needed at 6 hours postoperatively in the TAP group; none required in the DPN group within 24 hours.

Conclusions:

  • Ultrasound-guided DPN block provides effective, long-lasting postoperative analgesia for pediatric circumcision.
  • DPN block resulted in significantly lower pain scores than TAP block.
  • TAP block alone was insufficient for adequate postoperative analgesia in this study.
Abstract

Keywords:
CircumcisionDorsal penile nerve blockTransversus abdominis plane block

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