Effect of Different Anesthesic Agents on Surgical Site Bleeding During Circumcisions

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Objective: To investigate the effects of ketamine+midazolam and propofol+fentanyl+lidocaine anesthesia on surgical site bleeding during circumcision procedures. Materials and Methods: A total of 100 boys (aged 1-8 years) schedule for circumcision were included in the study. Patients were randomly divided into two groups. In the Group I (n=50), 0.01 mg/kg intravenous midazolam and 2 mg/kg intravenous ketamine were administered. In the Group II (n=50), 1microg/kg intravenous fentanyl, 1 mg/kg intravenous lidocaine, and 2-3 mg/kg intravenous propofol were administered and patency of airway was ensured with laryngeal mask airway. The intraoperative bleeding scale recorded during the procedure to evaluate surgical site bleeding. Dressing was checked to follow up bleeding throughout the postoperative. Results: Intraoperative bleeding scores were significantly higher in Group I as compared to Group IIduring circumcision procedures. However, there was no significant difference between the groups in amount of bleeding for postoperative period. Conclusion: Although intraoperative bleeding scores are significantly higher in ketamine+midazolamgroup compared to propofol+fentanyl+lidocaine group, this kind of bleeding can be easily controlled with appropriate hemostasis. Nevertheless ketamine should be carefully applied in patients with bleeding diathesis.