Comparison of postoperative analgesic effectiveness of caudal block, dorsal penile nerve block, and pudendal nerve block in children undergoing circumcision

Abstract

Purpose: This study aimed at comparing the postoperative analgesic effectiveness of three types of nerve blocks (caudal block, dorsal penile nerve block (DPNB), and pudendal nerve block (PNB) in children undergoing circumcision.
 Materials and Methods: In this retrospective study, patient records of those who underwent circumcision during an 18-month period were included in this study. Data collected included demographics, intraoperative hemodynamic parameters, nerve block application time, rescue analgesic time, duration of anesthesia and surgery, recovery time, and postoperative complications. Postoperative pain was evaluated using the Face, Legs, Activity, Cry, Consolability (FLACC) pain scale.
 Results: A total of 216 male patients, aged 2-12 years, were included in this study. The majority received DPNB (n= 78), followed by caudal block (n= 72) and PNB (n= 66). The FLACC pain scores were significantly higher in the DPNB group. Rescue analgesics were required by 49 patients, all of whom were in the DPNB group. Postoperative complications were more frequently observed among those with the caudal block, compared to DPNB and PNB.
 Conclusion: Caudal and pudendal nerve block had the highest effectiveness in terms of postoperative analgesia in patients undergoing circumcision. The decision of choosing between them should take into account the experience of the practitioner, as well as side effects.