Comparison of postoperative analgesic efficacy of penile block, caudal block and intravenous paracetamol for circumcision: a prospective randomized study.
OBJECTIVE
To evaluate the postoperative analgesic efficacy of penile block, caudal block and intravenous paracetamol administration following circumcision.


METHODS
In this prospective randomized study a total of 159 patients underwent circumcision under general anesthesia at urology clinic of Ufuk University Faculty of Medicine and Sorgun State Hospital between May 2012 and September 2012. The patients were randomized to three groups to receive penile block (Group 1), caudal block (Group 2) and intravenous paracetamol administration (group 3). Pain measurement of the patients was done via CHEOPS scoring system at 30,60,120 and 180 minutes postoperatively and compared. Statistical tests were performed with a conventional statistics program and statistical significance was set at a p value of < 0.05.


RESULTS
The mean age of the patients was 5.7 years. Patients in group 1 had significantly lower pain score at 30 minutes compared to other two groups. At 60 minutes groups 1 and 2 had significantly lower score compared to group 3. At 120 and 180 minutes no difference between the groups was observed. No significant major complications were observed in all 3 groups.


CONCLUSIONS
Penile block and caudal block provide similar pain scores and painless postoperative periods after circumcision under general anesthesia. Intravenous paracetamol is insufficient at the early postoperative period. The three procedures were shown to be safe for analgesia following circumcision.
Ufuk University, Department of Urology Faculty of Medicine, Ankara, Turkey.
Ahmet Hakan
AH
Haliloglu
Mehmet Ilker
MI
Gokce
Semih
S
Tangal
Mehmet Salih
MS
Boga
Hakan
H
Tapar
Ebru
E
Aladag
D000082:Acetaminophen / Q000008:administration & dosage*; D061605:Administration, Intravenous; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000763:Anesthesia, Caudal / Q000379:methods*; D002675:Child, Preschool; D002944:Circumcision, Male; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen