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Updated: Sep 9, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Pain Management and Postoperative Outcomes in Circumcisions
Sophia Perez1, Jami Alamar1, Rachel Siretskiy1
1Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA.
Insights
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.
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.
Abstract:
Opioid stewardship efforts with non-narcotic analgesic regimens in the perioperative setting optimize outcomes. Standardized protocols for pediatric patients undergoing circumcision are lacking. To evaluate current practices, a retrospective chart review was conducted on 354 pediatric patients who underwent circumcision at a children's hospital. Analgesic use, intraoperative block use, and patient outcomes were analyzed. Intraoperatively, 57.6% of patients received at least one narcotic analgesic, with 28.4% receiving additional doses. Patients who underwent a caudal block required no narcotics at any phase, while those without a block received narcotics in the perioperative period. Outcomes were similar between patients who did or did not receive caudal blocks or NSAIDs, specifically, there was no difference in incidence of bleeding. These findings suggest that regional nerve blocks and NSAIDs may not increase risk and may provide effective pain control for pediatric patients undergoing circumcisions, reducing or eliminating the need for narcotics and therefore optimizing care.
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