A retrospective audit of three different regional anaesthetic techniques for circumcision in children

作者：Sandeman D J^*; Reiner D; Dilley A V; Bennett M H; Kelly K J

来源：Anaesthesia and Intensive Care, 2010, 38(3): 519-524.

• circumcision
• ultrasound guidance
• dorsal penile nerve block
• caudal epidural analgesia

Postoperative analgesia for male circumcision surgery has been traditionally provided by a landmark-based dorsal penile nerve block (DPNB-LM) or by caudal epidural analgesia (CEA). In this study we report on a retrospective analysis of the effectiveness and safety of CEA, DPNB-LM and ultrasound-guided dorsal penile nerve block (DPNB-US) in our institution over a six-year period. Information was gathered from each pollen! Is medical record. A total of 216 circumcisions were performed on patients aged from,five months to 15 years. One hundred and fifteen patients received CEA, 46 DPNB-LM and 55 DPNB-US. Patients in the DPNB-LM group required rescue morphine administration in the recovery unit more frequently (30.4%) than either the DPNB-US (3.5%) or CEA groups (3.6%). Similarly the DPNB-LM group required a larger total dose of morphine, and had longer recovery ward stays than CEA or DPNB-US groups. Time to first analgesia was greatest for the CEA group while there was no significant difference between time to first analgesia for DPNB-LM and DPNB-US. Sixty-three percent of patients in the DPNB-LM group, 1.7% of CEA and 5.5% of the DPNB-US required intraoperative opiates (P <0.0001). There was no difference in time to hospital discharge.

• 出版日期2010-5