Hypospadias, Postoperative Pain
Conditions
Keywords
dorsal penile nerve block, caudal epidural block, postoperative pain, analgesia, hypospadias, ultrasound
Brief summary
Hypospadias, seen in every 200-300 births, is one of the most common congenital anomalies of the penis and is defined as the urethral meatus being located in the ventral part of the penis instead of its normal place. The surgery of this anomaly is very painful in the postoperative period and requires long-term analgesia. Regional anesthesia methods combined with general anesthesia play an important role in providing effective and long-term postoperative pain control in pediatric penile surgery. These methods also reduce postoperative morbidity, enable early mobilization and significantly decrease the need for narcotic analgesics. The investigator's hypothesis is peripheral nerve blocks are superior to neuraxial blocks as the blocks provide longer-term analgesia and have fewer side effects.
Detailed description
The surgery of hypospadias is very painful in the postoperative period and requires long-term analgesia. A dorsal penile nerve block (DPNB) and caudal epidural block (CEB) are commonly used regional anesthesia techniques for postoperative pain control. Aims: The primary aim of the current study was to use the duration until the first postoperative analgesic requirement after two different block techniques to compare the analgesic effect. The secondary aims were to compare the two methods for postoperative Children's Hospital Eastern Ontario Pain Scale (CHEOPS) scores, complications and parental satisfaction scores.
Interventions
None listed
Sponsors
Prof. Dr. Cemil Tascıoglu Education and Research Hospital Organization
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
MALE
Age
1 Years to 7 Years
Healthy volunteers
No
Inclusion criteria
* 1-7 years of age * ASA (American Society of Anesthesiologists) I-II group * Scheduled for distal hypospadias surgery * Able to communicate in Turkish * Willing to participate to the study (parents and children)
Exclusion criteria
* Less than 1 or more than 7 years of age * A neurological deficit, bleeding diathesis, or a history of local anesthetic allergy; an infection or redness in the injection area, congenital low back anomaly, liver disorder, a psychiatric disorder, mental retardation, or communication problems detected during examination * Unwilling to to participate to the study ((parents or children)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time of Postoperative analgesic requirement | Up to 24 hours | It was assessed six times after the operation with Children's Hospital Eastern Ontario Pain Scale. The lowest scale score is 4 points and the highest 13 points. Significant pain behavior for Children's Hospital Eastern Ontario Pain Scale has been identified as 7 points or more. Following transfer from the recovery unit to the ward, the 1st, 2nd, 6th, 12th and 24th hour pain levels were evaluated by the ward nurse. Paracetamol was administered IV at a dose of 10 mg/kg if the scale score was 7 or higher. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Level of Postoperative pain | Up to 24 hours | It was assessed six times after the operation with Children's Hospital Eastern Ontario Pain Scale. The lowest scale score is 4 points and the highest 13 points. Significant pain behavior for Children's Hospital Eastern Ontario Pain Scale has been identified as 7 points or more. Following transfer from the recovery unit to the ward, the 1st, 2nd, 6th, 12th and 24th hour pain levels were evaluated by the ward nurse. |
| Rate of Postoperative complications | Up to 24 hours | Urinary retention, nausea, vomiting, lower extremity numbness, motor block were postoperative complications. They were assessed by ward nurse. |
| Level of Parent satisfaction | Up to 24 hours | The parents were asked about their satisfaction with the child's comfort and activity level \[1, unsatisfied; 2, satisfied (good); 3, absolutely satisfied (excellent)\] at the 24-hour follow-up |
Countries
Turkey (Türkiye)
Outcome results
None listed