Elective Circumcision Surgery
Conditions
Keywords
Sacral ESPB, Penile Block, Pediatric Regional Anesthesia, Circumcision, FLACC Score, Opioid Consumption
Brief summary
Effective perioperative analgesia is crucial for reducing hospital stay in pediatric surgical patients. Opioid-based analgesia, although effective, may lead to respiratory depression in the postoperative period. Therefore, alternative regional anesthesia techniques such as penile block and sacral ESPB are increasingly preferred. Sacral ESPB provides both somatic and visceral analgesia by blocking the dorsal and ventral rami of the spinal nerves. It has the potential to block the pudendal nerve and achieve bilateral effect with a single midline injection. However, comparative data between sacral ESPB and penile block in circumcision surgeries is limited.
Detailed description
Effective perioperative analgesia is crucial for reducing hospital stay in pediatric surgical patients. Opioid-based analgesia, although effective, may lead to respiratory depression in the postoperative period. Therefore, alternative regional anesthesia techniques such as penile block and sacral ESPB are increasingly preferred. Sacral ESPB provides both somatic and visceral analgesia by blocking the dorsal and ventral rami of the spinal nerves. It has the potential to block the pudendal nerve and achieve bilateral effect with a single midline injection. However, comparative data between sacral ESPB and penile block in circumcision surgeries is limited. In this prospective, double-blind, randomized controlled trial, 62 children aged 2 to 7 years undergoing elective circumcision at the Department of Pediatric Surgery of Diyarbakır Gazi Yaşargil Training and Research Hospital will be randomly assigned to two groups: Group I will receive sacral ESPB using 0.8 mL/kg of 0.25% bupivacaine Group II will receive a penile block using the same dosage and concentration. Primary outcomes include intraoperative opioid use and postoperative rescue analgesic consumption within 24 hours. Secondary outcome includes time to discharge. Hemodynamic parameters and FLACC scores will be monitored at defined intervals.
Interventions
DRUG0.8 mL/kg of 0.25% bupivacaine
0.8 mL/kg of 0.25% bupivacaine
Sponsors
Siirt Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
2 Years to 7 Years
Healthy volunteers
No
Inclusion criteria
ASA I pediatric patients aged 2-7 years Scheduled for elective circumcision Informed consent obtained from parents/legal guardians
Exclusion criteria
ASA score other than I Age \<2 or \>7 years Known allergy to local anesthetics Refusal to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| FLACC Pain Score | From arrival in the recovery room until 24 hours postoperatively | Postoperative pain will be assessed using the FLACC (Face, Legs, Activity, Cry, Consolability) scale at 0, 15, 30, 45, 60, 90 minutes, and 2, 4, 6, 8, 10, 12, 18, and 24 hours after surgery. A FLACC score ≥4 will be treated with rescue analgesia. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total Perioperative Opioid and Rescue Analgesic Consumption | Up to 24 hours postoperatively | Measured as total intraoperative fentanyl usage and postoperative administration of paracetamol and ibuprofen. |
Contacts
Primary Contactali K oğuz, specialist doctor in anestesio
Outcome results
None listed