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Sedation-Only Anesthesia for Pediatric Circumcision: A Safer Alternative

A A Özdeş1, Z Korhan1, M Beler2

  • 1Department of Urology, Karakoçan State Hospital, Elazığ, Turkey.

Nigerian Journal of Clinical Practice
|September 27, 2025
PubMed

Insights

Sedation-only anesthesia effectively manages pain after pediatric circumcision. Combining sedation with local anesthesia did not improve pain control and led to more local complications.

Area of Science:

  • Pediatric Anesthesiology
  • Surgical Pain Management

Background:

  • Pediatric circumcision is a common procedure requiring effective pain management.
  • The optimal anesthesia technique for pediatric circumcision remains a subject of debate.

Purpose of the Study:

  • To compare the efficacy and safety of sedation-only anesthesia versus combined sedation and local anesthesia for pediatric circumcision.
  • To evaluate postoperative pain and local complications in children undergoing circumcision.

Main Methods:

  • A prospective study involving 140 boys (aged 1-6 years) randomly assigned to sedation alone or sedation plus local anesthesia.
  • Both groups received a standardized intravenous sedative regimen including midazolam, propofol, fentanyl, and ketamine.
  • Postoperative pain was assessed using the FLACC scale at 1 and 3 hours, with complications recorded.

Main Results:

  • No significant difference in postoperative pain scores (FLACC scale) was observed between the sedation-only group and the combined anesthesia group at 1 and 3 hours.
  • Local complications, including ecchymosis and edema, were more frequent in the group receiving local anesthesia (15.7%) compared to the sedation-only group (7.1%).

Conclusions:

  • Sedation-only anesthesia with midazolam, propofol, fentanyl, and ketamine provides effective pain control for pediatric circumcision.
  • Combining sedation with local infiltration anesthesia does not enhance pain relief and is associated with a higher incidence of local complications.
Abstract

Keywords:
Circumcisionlocal anesthesiapediatric anesthesiapostoperative painsedation analgesia

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