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Pain Management and Postoperative Outcomes in Circumcisions.

Sophia Perez1, Jami Alamar1, Rachel Siretskiy1

  • 1Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA.

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Summary

Non-narcotic pain management, including caudal blocks and NSAIDs, can effectively control pain for pediatric circumcision patients. This approach reduces or eliminates the need for narcotics, optimizing patient care.

Keywords:
ERASotherpediatric surgerysurgical quality

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Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Anesthesiology

Background:

  • Opioid stewardship is crucial for optimizing perioperative outcomes.
  • Standardized non-narcotic analgesic protocols for pediatric circumcision are lacking.
  • Current practices often involve narcotic analgesics in pediatric circumcision.

Purpose of the Study:

  • To evaluate current analgesic practices for pediatric circumcision.
  • To assess the role of regional nerve blocks and NSAIDs in pain management.
  • To determine the impact on narcotic use and patient outcomes.

Main Methods:

  • Retrospective chart review of 354 pediatric patients undergoing circumcision.
  • Analysis of intraoperative analgesic and nerve block use.
  • Evaluation of patient outcomes, including narcotic requirements and bleeding incidence.

Main Results:

  • 57.6% of patients received intraoperative narcotics; 28.4% received additional doses.
  • Patients receiving caudal blocks required no perioperative narcotics.
  • No significant difference in bleeding incidence was observed between groups receiving caudal blocks or NSAIDs versus those who did not.

Conclusions:

  • Regional nerve blocks (caudal) and NSAIDs can provide effective pain control for pediatric circumcision.
  • These non-narcotic strategies may significantly reduce or eliminate the need for perioperative narcotics.
  • Implementing regional anesthesia and NSAIDs may optimize care and improve opioid stewardship in pediatric circumcision.