Comparison of Caudal Block vs. Penile Block in Terms of Surgical Incision Response for Circumcision and Postoperative Analgesia Requirements

Abstract

Circumcision is a frequently performed surgery in children worldwide. For circumcision, penile and caudal epidural blocks are commonly used. Nerve blocks not only decrease the systemic analgesia requirements intra-operatively but also increase the length of pain relief postoperatively. The aim of the present study was to compare the surgical incision response in circumcision, in children with a caudal block and penile block. We also compared the systemic analgesic requirements postoperatively in both groups.
 Materials and Methods: The study was conducted in pediatric patients. Total of 30 samples (n = 30) was taken and divided into two groups of 15 each. The group A received caudal block and group B received penile block. The blocks were performed after general anesthesia. We tried our best to eliminate all the factors which can lead to tachycardia (such as hypoxia, light plane of anesthesia, hyperthermia and hypothermia, hypercarbia, hypovolemia etc). The patients were keenly observed for change in heart rate on incision, the heart rates were recorded before and at incision (surgical incision response) in both groups. The postoperative consumption of the pain killers were also noted in both the groups.
 Results: We observed that the patients in group A with caudal block did not show any significant surgical response, whereas in group B patients with penile block showed increased heart rate at the incision. There was no complain of pain in group A in the recovery period. Whereas complains of pain were recorded in most of the children in group B, hence pain killers were given to the patients in this group.
 Conclusion: Our data proved that the caudal block was better than the penile block in terms of pain relief.