Levobupivacaine for Postoperative Pain Management in Circumcision; Caudal Blocks or Dorsal Penile Nerve BlockZüleyha Kazak Bengisun1, Perihan Ekmekci1, Ahmet Hakan Haliloglu2
1Ufuk University Faculty Of Medicine Department Of Anesthesiology And Reanimation
2Ufuk University Faculty Of Medicine Department Of Urology
Purpose: In this study, we evaluated the analgesic efficacy and adverse effect profile of levobupivacaine in caudal and DPNB in postcircumcision pediatric patients.Keywords: Circumcision, Caudal Blocks, Penile Block; Levobupivacaine
Methods: Sixty boys between 2-10 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 and 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, 30th minutes, 1th, 2 th, 3 th, 4 th, 5 th and 6th hours. The number of pain free patients for the first 6 hours, duration of analgesia, time to first analgesic administration, walking, micturition, and total paracetamol demands, and length of stay were recorded.
Results: Demographic 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.
Conclusion: Caudal block done by 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 a risk for motor block.
Züleyha Kazak Bengisun, Perihan Ekmekci, Ahmet Hakan Haliloglu. Levobupivacaine for Postoperative Pain Management in Circumcision; Caudal Blocks or Dorsal Penile Nerve Block. Ağrı. 2012; 24(4): 180-186
Corresponding Author: Züleyha Kazak Bengisun, Türkiye