Factors associated with early postoperative analgesic requirement after pediatric circumcision

To evaluate early postoperative analgesic requirement within the first 6 h after pediatric circumcision performed under a standardized surgical and anesthetic protocol and to identify associated factors.

This retrospective study included pediatric patients who underwent elective circumcision using the dorsal slit technique. All procedures were performed by a single surgeon under deep sedation combined with penile block, with anesthetic management provided by a single anesthesiologist. Postoperative pain was assessed using the Modified Pediatric Objective Pain Scale (MPOPS) at 30, 60, and 90 min and at 3, 6, and 12 h postoperatively. The primary outcome was early postoperative analgesic requirement within the first 6 h. Demographic, clinical, and procedural variables were analyzed using univariate analyses and multivariate logistic regression.

A total of 167 patients were initially assessed, and 136 were included after applying the exclusion criteria. Early postoperative analgesic requirement was observed in 51 patients (37.5%). In univariate analysis, body weight and duration of surgery were significantly associated with analgesic requirement (p < 0.05). Multivariate logistic regression showed that both body weight (OR: 1.068; 95% CI: 1.021-1.118) and operative duration (OR: 1.148; 95% CI: 1.068-1.234) were independent predictors. MPOPS scores were consistently higher over time in patients who required analgesia.

In pediatric circumcision performed under standardized surgical and anesthetic conditions, increased body weight and longer operative duration were independently associated with early postoperative analgesic requirement. Awareness of these factors may help optimize postoperative pain management strategies in pediatric patients undergoing circumcision.