Child, Only
Conditions
Keywords
dorsal nerve penis block, sedation, spontaneous breathing, circumcision, pediatric surgery, ultrasound guided
Brief summary
One of the most frequent surgical procedures in the pediatric population is circumcision, following which postoperative pain could be stressful. Usually, the most common approach is combining regional anesthesia techniques such as landmark dorsal penile nerve block (DPNB) with general anesthesia (GA). The hypothesis of this study investigates ultrasound-guided DPNB plus sedation in spontaneous breathing.
Interventions
This block is performed by the anesthesiologist, after sedation. With an in-plane approach, the tissues around the dorsal penis nerves are visualized. The needle has to pass through Buck's fascia and there the local anesthetic is released.
Sponsors
Azienda Sanitaria-Universitaria Integrata di Udine
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
MALE
Age
6 Months to 17 Years
Healthy volunteers
No
Inclusion criteria
* candidates to circumcision * age between 6 months and 17 years * American Society of Anesthesiologists (ASA) physical status \< 3 * written consent of the parents
Exclusion criteria
* allergies to local anesthetics * younger than 6 months and older than 17 years * ASA physical status =/\> 3 * no written consent of the parents
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to discharge | 1 hour after end of surgery | The time to discharge from the operating room to the post-anesthesia care unit is measured and compared between the two groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients needed ventilation | 1 hour after beginning of surgery | Patients who received general anesthesia where all ventilated mechanically. In the ultrasound group, patients maintained spontaneous breathing and were noted the ones who needed ventilation. |
| Opioid sparing | 1 hour after beginning of surgery | The dosage of opioids were measured and compared between the two groups. |
| Postoperative pain | Immediately after surgery, 4 and 72 hours after surgery | Pain levels were compared between the two groups with the Faces, Legs, Activity, Cry and Consolability (FLACC) scale for children \< 3 years (a score between 0 and 3 corresponds to a slight pain, in the range 4-7 to moderate pain and score\> 7 to a severe pain), faces pain scale for children between 3 e 8 years (the scale shows a series of faces ranging from a happy face or no hurt at score 0, to a crying face at score 10, which represents hurts like the worst pain imaginable, the patient chooses the face that best describes their level of pain) and the numerical rate scale (NRS) for children \> 8 years-old (patients are asked to circle the number between 0 and 10 that fits best to their pain intensity, zero represents 'no pain at all' whereas the upper limit represents 'the worst pain ever possible'). Analgesics and nonsteroidal anti-inflammatory drugs were registered in the two groups. |
| Complications | Immediately after surgery, 4 and 72 hours after surgery | Postoperative complications were analyzed and compared between the two groups. |
Countries
Italy
Outcome results
None listed