Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences
  • Register
  • Login

Urology Journal

  • Home
  • Instant Online
    • Instant 2022
    • Instant 2021
    • Instant 2020
  • Current
  • Archives
  • Announcements
  • Submissions
  • Author Guidelines
  • About
    • About the Journal
    • Privacy Statement
    • Contact
Advanced Search
  1. Home
  2. Archives
  3. Vol. 15 No. 3 (2018): May-June2018
  4. ORIGINAL PAPER (PEDIATRIC UROLOGY)

ISSN: 1735-1308

May-June2018
Vol. 15 No. 3 (2018)

Pudendal Nerve Block Versus Penile Nerve Block in Children Undergoing Circumcision

  • Ayse Cigdem Tutuncu
  • Pinar Kendigelen
  • Gulruh Ashyyeralyeva
  • Fatis Altintas
  • Senol Emre
  • Rahsan Ozcan
  • Guner Kaya

Urology Journal, Vol. 15 No. 3 (2018), , Page 109-115
https://doi.org/10.22037/uj.v0i0.4292 Published 3 May 2018

  • View Article
  • Download
  • Cite
  • References
  • Statastics
  • Share

Abstract

Purpose: Penile nerve block is the most popular nerve block for the circumcision in pediatric patients. This study aimed to compare the analgesic efficiency of penile nerve block and the pudendal nerve block on postoperative pain and additional analgesic requirements in children undergoing circumcision.
Material and Methods: This prospective randomized double-blind study enrolled 85 children, aged 1 to10 years, undergoing circumcision. The patients were randomly divided into two groups either receiving dorsal penile block group (PNB-Group) or pudendal nerve block (PDB-Group). In the PNB-Group, 0.3 ml/kg 0.25 % bupivacaine was used; and, in the PDB-Group, 0.3 ml/kg bupivacaine was applied with nerve stimulator at a concentration of 0.25%. In the postoperative period, the modified CHEOPS pain scale scoring and additional analgesic demand were evaluated at the 5th and 30th minutes and at the 1st and 2nd hours. The subsequent pain evaluations were made by the parents at home, at the postoperative 6th, 12th, 18th and 24th hours.
Results: Seven patients were excluded from the study, and seventy eight patients were evaluated for analysis. Patients in PDB-Group had significantly lower postoperative pain intensity and lower mCHEOPS scores (3.83 ± 0.98) when compared to the PNB-Group (6.47 ± 0.91) (P < .01) at all measurement times and none of patients in PDB-Group had additional analgesic requirements up to 24 hours. Patients in the PNB-Group had significantly more analgesic requirements at all measurements times except at the 1st, 2nd, 24th hours. 3.8%, 30.8%, 46.2% and 59% of the patients in the PNB group needed additional analgesia respectively at 5th, 6th, 12th and 18th hours.
Conclusion: Pudendal nerve block provided additional analgesic free period and had better analgesic efficiency compared to the penile nerve block lasting until 24 hours after operation.
  • PDF

How to Cite

Tutuncu, A. C., Kendigelen, P., Ashyyeralyeva, G., Altintas, F., Emre, S., Ozcan, R., & Kaya, G. (2018). Pudendal Nerve Block Versus Penile Nerve Block in Children Undergoing Circumcision. Urology Journal, 15(3), 109-115. https://doi.org/10.22037/uj.v0i0.4292
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

References

Cyna AM, Middleton P. Caudal epidural block versus other methods of postoperative pain relief for circumcision in boys. Cochrane Database Syst Rev. 2008; 8: 2-6.

Dalens B, Vanneuville G, Dechelotte P Penile block via the subpubic space in 100 children. Anesth Analg. 1989; 1: 41-5.

Reitz A, Gobeaux N, Mozer P, Delmas V, Richard F, Chartier-Kastler E. Topographic anatomy of a new posterior approach to the pudendal nerve for stimulation. Eur Urol. 2007; 5 : 1350-5.

Kendigelen P, Tutuncu AC Emre S, Altindas F, Kaya G. Pudendal versus caudal block in children undergoing hypospadias surgery: A randomized controlled study Reg Anesth Pain Med. 2016; 5: 610-5.

Hecht S, Piñeda J, Bayne A. Ultrasoundguided pudendal block is a viable alternative to caudal block for hypospadias surgery: a single surgeon pilot study. Urology 2017; S0090-4295: 31197-4.

Bellieni CV, Alagna MG, Buonocore G. Analgesia for infants' circumcision Ital J Pediatr. 2013; 39: 1-7.

Allan CY, Jacqueline PA, Shubhda JH. Caudal epidural block versus other methods of postoperative pain relief for circumcision in boys. Cochrane Database Syst Rev. 2003; 2: 2-8.

Soh CR1, Ng SB, Lim SL. Dorsal penile nerve block. Paediatr Anaesth. 2003; 4: 329-33.

Yang CC, Bradley WE. Neuroanatomy of the penile portion of the human dorsal nerve of the penis. B J Urol. 1998; 82: 109-113.

Faraoni D, Gilbeau A, Lingier P, Barvais L, Engelman E, Hennart D. Does ultrasound guidance improve the efficacy of dorsal penile nerve block in children? Paediatr Anaesth. 2010; 10: 931-6.

Sandeman DJ1, Dilley AV. Ultrasound guided dorsal penile nerve block in children. Anaesth Intensive Care. 2007; 2: 266-9.

Brown TCK, Weidner NJ, Bouwmeester J. Dorsal nerve of the penis block-anatomical and radiological studies. Anaesth Intensive Care. 1989; 17: 34-8.

Serour F, Mori J, Barr J. Optimal regional anesthesia for circumcision. Anesth Analg. 1994; 79: 129-31.

Naja Z, Al-Tannir MA, Faysal W, Daoud N, Ziade F, El-Rajab M. A comparison of pudendal block vs dorsal penile nerve block for circumcision in children: a randomized controlled trial. Anesthesia. 2011; 9: 802-7.

Hruby S, Ebmer J, Dellon AL, Aszmann OC. Anatomy of pudendal nerve at urogenital diaphragm--new critical site for nerve entrapment. Urology. 2005; 5: 949-52.

Schmidt RA. Technique of pudendal nerve localization for block or stimulation. J Urol. 1989; 6: 1528-31.

Sfez M, Le Mapihan Y, Mazoit X, Dreux-Boucard H. Local anesthetic serum concentrations after penile nerve block in children. Anesth Analg. 1990; 4: 423-6.

  • Abstract Viewed: 1374 times
  • PDF Downloaded: 587 times

Download Statastics

  • Linkedin
  • Twitter
  • Facebook
  • Google Plus
  • Telegram

In case of persistent problems in registration, primary uploading of a submission or uploading of a revision, please send us the submission files on the journal email at:

urologyjournal@sbmu.ac.ir

and please attach the screenshot of the error or problem you encountered in uploading.

 

Make a Submission

          Journal Research in Urology

Information
  • For Readers
  • For Authors
Keywords
  • Home
  • Archives
  • Submissions
  • About the Journal
  • Editorial Team
  • Contact
The template of this website is designed by Sinaweb