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STEPPING INTO DORSAL PENILE BLOCK AND RING PENILE BLOCK APPROACH FOR CIRCUMCISION ANALGESIA
ESRA Academy. Martins A. Sep 8, 2016; 138340; 0175 Topic: Paediatric Population
Ana Martins
Ana Martins

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Abstract
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Background and Aims:

Circumcision is the most common surgical procedure carried out in young male patients globally. Dorsal and ring penile blocks are commonly employed for pain relief for penile surgery. Regional techniques have shown to be more effective than systemic opioids, non-steroid anti-inflammatory drugs, and acetaminophen for postoperative analgesia in circumcision. Circumcision is a painful and stressful procedure in children. Postoperative pain is an important problem and its relief is necessary.

Methods:

Retrospective study in male children scheduled for routine circumcision from 2013 to 2015. Circumcision procedures carried out with ring or dorsal penile block were registered.       

The blocks were performed after induction of anaesthesia with 0,15ml/Kg of 0,2% ropivacaine. Intraoperatively a single dose of fentanyl (3mcg/Kg) was administered. Postoperative analgesia with acetominophen (15mg/Kg) and metamizol (20mg/Kg) was prescribed. Complications related to block and administration of rescue analgesics and adverse effects were recorded postoperatively.

Results:

101 male children aged between 1 and 17 years. 66 children were ASA I(65,3%).

Circumcision was carried out with dorsal penile block in 64 (63,4%), ring penile block in 27 (26,7%) and combined dorsal and ring penile blocks in 10 (9,9%) patients.

No technique failures or complications related to each block were recorded. No patients required rescue analgesics in the immediate postoperative period. 

Conclusions:

Dorsal and ring penile block are easily regional anesthesia techniques with a low complication rate. They seem to be an effective alternative for pain relief, reducing perioperative opioid consumption and their related adverse effects.

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