Penile block for circumcision? A comparison with caudal blockade

A prospective blind trial was conducted comparing the analgesia and adverse effects produced by caudal extradural blockade (caudal block) with blockade of the dorsal nerves of the penis (penile block) in 38 boys undergoing elective circumcision. Analgesia was assessed by senior nurses using a linear analogue scale and by the response to direct questioning over the first 7 hours after surgery. The degree and duration of postoperative analgesia was similar in the two groups. However, the caudal block group had a higher incidence of motor blockade (p = less than 0.01). One technical failure occurred in the penile block group. It is concluded that a penile block is a satisfactory alternative to caudal blockade with regard to postoperative analgesia and offers several specific advantages.