title: Is penile block better than caudal epidural block for postcircumcision analgesia?
abstract: OBJECTIVE
  To compare caudal and penile block for post-operative analgesia in children undergoing circumcision with respect to efficacy, complication rates, and parental satisfaction.
  
  
  METHODS
  The study population consisted of 100 ASA 1 and 2 boys aged 3 to 8 years who were undergoing circumcision for religious reasons. In all participants, inhalation anesthesia was administered with oxygen : nitrous oxide (1 : 2) and halothane. The participants were allocated randomly into two groups of 50 children each. Group 1 received penile block and Group 2 caudal block. The penile block was achieved by injecting bupivacaine into the two compartments of the subpubic space, with an additional ventral infiltration of a small volume of bupivacaine along the raphe of the penis. For caudal block, 1 ml.kg(-1) body weight of 0.25% bupivacaine was administered.
  
  
  RESULTS
  Penile block shortened the induction-incision time and enabled earlier discharge home compared with caudal block. One patient undergoing penile block and nine patients undergoing caudal block vomited.
  
  
  CONCLUSIONS
  Penile and caudal block are equally effective for postcircumcision analgesia and neither is associated with serious complications. Anesthesiologist preference should be the deciding factor in choosing one technique over the other.
authors.affiliation: Division of Anesthesiology and Critical Care, Soroka Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, 84101, Israel.
authors.forename: Natan
authors.initials: N
authors.lastname: Weksler
authors.forename: Iehuda
authors.initials: I
authors.lastname: Atias
authors.forename: Moti
authors.initials: M
authors.lastname: Klein
authors.forename: Vsevolod
authors.initials: V
authors.lastname: Rosenztsveig
authors.forename: Leon
authors.initials: L
authors.lastname: Ovadia
authors.forename: Gabriel M
authors.initials: GM
authors.lastname: Gurman
mesh_terms: D000293:Adolescent; D015360:Analgesia, Epidural; D000768:Anesthesia, General; D002648:Child; D002944:Circumcision, Male / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010290:Parents; D017060:Patient Satisfaction; D010413:Penis / Q000294:innervation