A Comparative Study of Penile Block Versus General Anaesthesia in Pediatric Urological Surgeries

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A Comparative Study of Penile Block Versus General Anaesthesia in Pediatric Urological Surgeries

Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10

Abstract

Introduction: Surgical pain relief in children can be given by general anaesthesia or by regional nerve blocks. The present study was carried out to evaluate the effectiveness of penile block for penile surgeries with the standard technique of general anaesthesia (GA) of duration of less than two hours, and also to evaluate the postoperative analgesia obtained by penile block. Objectives of the study: We designed a study in our hospital to compare the effectiveness of penile block for penile surgery with standard technique of general anaesthesia of duration of less than two hours and to evaluate the postoperative analgesia obtained by penile block. Materials & methods: 60 children between the age of 1 and 10 years belonging to American Society of Anesthesiologists (ASA) grades I and II were included in the present study randomly and divided into two groups of 30 each: Group B and group G. Intra-operatively, HR, ECG, NIBP (systolic and diastolic) and SpO2 were recorded at 5 minute intervals for the first 60 min and then at 15 minute intervals till the end of procedure.Post operatively, HR, NIBP, SpO2 and pain were assessed and recorded at 15 minutes, 1 hour, 4 hours and 8 hours. The time to first feed and the first rescue analgesic were also recorded. Any complications or side effects due to the block or GA were also observed and recorded. Results: None of the patients in group B required any supplemental analgesia. However, all children in this group needed midazolam 0.01 mg/kg to avoid anxiety and to prevent minor movements of limbs. All the children in group G for whom surgery lasted 45 minutes or longer needed additional additional doses of fentanyl (n=10). Post operative heart rate in group G was significantly more than group B at all the four time intervals (P<0.0001). The average time for rescue analgesia was 287.0 ± 54.4 minute in group G while it was 562.0 ± 300 in group B (P<0.001). The mean time to first feed post operatively was 91 ± 49.97 in group G whereas it was 77.5 ± 17.76 minute in group B (P<0.001).There were no complications due to the block such as edema, hematoma or bleeding. Conclusions: Penile block is very effective when used along with sedation for short (<2 hours) distal penile surgeries when compared to standard GA as reflected by more stable haemodynamics in peri-operative period, excellent pain relief up to 6-8 hrs postoperatively and paucity of any significant complications or side effects.

Authors and Affiliations

Danny Darlington C, Raju S

Keywords

EP ID EP243719
DOI 10.9790/0853-1610067577
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