• Agri · Jan 2012

    Randomized Controlled Trial

    Levobupivacaine for postoperative pain management in circumcision: caudal blocks or dorsal penile nerve block.

    • Züleyha Kazak Bengisun, Perihan Ekmekci, and Ahmet Hakan Haliloğlu.
    • Department of Anesthesiology and Reanimation, Ufuk University, Faculty of Medicine, Ankara, Turkey. kazakzuleyha@yahoo.com
    • Agri. 2012 Jan 1;24(4):180-6.

    ObjectivesIn this study, we evaluated the analgesic efficacy and adverse effect profile of levobupivacaine in caudal and DPNB in postcircumcision pediatric patients.MethodsSixty boys between 2-10 years of age undergoing circumcision were enrolled. The patients were divided into two groups: Group C (n=30) and Group P (n=30) were applied caudal block or dorsal penile nerve block (DPNB), respectively. Blocks were performed before surgery as a supplement to general anesthesia with 1 mL kg(-1) 0.25% levobupivacaine. Postoperative pain and sedation scores were assessed on the 10th and 30th minutes, and hours 1-6. The number of pain free patients in the first 6 hours, the duration of analgesia, time to first analgesic administration, walking, micturition, and total paracetamol demands, and length of stay were recorded.ResultsDemographic data were similar between groups. The number of children who spent the first 6 hours pain-free was larger in Group C than Group P (p=0.0001). The time to first analgesic (p=0.000033) and walking (p=0.004) were longer in Group C. There were 14 patients with motor block in Group C (p=0.00007). In view of AUC, FPRS, OPS and MPOPS were significantly better in Group C on the first postoperative 6 hours.ConclusionCaudal block done using levobupivacaine for postoperative pain management in circumcision is more successful than penile block, however there is a significant delay in time to first walking and as might be expected there is an increased risk of motor block.

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