AIM AND OBJECTIVE: To evaluate the effect of penile block vs caudal epidural on the quality of analgesia and surgical outcome following hypospadias repair. BACKGROUND: Intraoperative penile engorgement because of caudal epidural may result in tension on surgical sutures and alter surgical outcome. METHODS:Fifty-four ASA I and II children were randomly allocated to group P (penile block, 0.25% bupivacaine, 0.5 mg·kg(-1) ; n = 27) and group C (caudal epidural, 0.25% bupivacaine, 0.5 ml·kg(-1) ; n = 27), respectively. Quality of analgesia was assessed by visual analog scale (VAS) score recorded at 0, 0.5, 3, 6, 12, 24 h, and once a day for the next 4 days. Duration of analgesia was calculated from the institution of block to the first analgesic demand by child or VAS > 5. Total morphine consumption in the first 48 h and oral paracetamol consumption till 5th day were recorded. Children were regularly followed up in their respective outpatient clinic for early or late complications. RESULTS: In group P, lower mean VAS scores were seen from 0.5 h after surgery till day 3 and analgesia lasted for significantly longer duration (82 min) when compared with caudal epidural, P < 0.001. Incidence of urethral fistula formation after primary hypospadias repair was 19.2%, and all had received caudal epidural. An increase of 27% in penile volume from baseline value was observed 10 min after caudal epidural placement, P < 0.05. CONCLUSION: Penile block provided better analgesia when compared with caudal epidural in children undergoing primary hypospadias repair. Postoperative urethral fistula formation was more likely in children who received caudal epidural.
RCT Entities:
AIM AND OBJECTIVE: To evaluate the effect of penile block vs caudal epidural on the quality of analgesia and surgical outcome following hypospadias repair. BACKGROUND: Intraoperative penile engorgement because of caudal epidural may result in tension on surgical sutures and alter surgical outcome. METHODS: Fifty-four ASA I and II children were randomly allocated to group P (penile block, 0.25% bupivacaine, 0.5 mg·kg(-1) ; n = 27) and group C (caudal epidural, 0.25% bupivacaine, 0.5 ml·kg(-1) ; n = 27), respectively. Quality of analgesia was assessed by visual analog scale (VAS) score recorded at 0, 0.5, 3, 6, 12, 24 h, and once a day for the next 4 days. Duration of analgesia was calculated from the institution of block to the first analgesic demand by child or VAS > 5. Total morphine consumption in the first 48 h and oral paracetamol consumption till 5th day were recorded. Children were regularly followed up in their respective outpatient clinic for early or late complications. RESULTS: In group P, lower mean VAS scores were seen from 0.5 h after surgery till day 3 and analgesia lasted for significantly longer duration (82 min) when compared with caudal epidural, P < 0.001. Incidence of urethral fistula formation after primary hypospadias repair was 19.2%, and all had received caudal epidural. An increase of 27% in penile volume from baseline value was observed 10 min after caudal epidural placement, P < 0.05. CONCLUSION:Penile block provided better analgesia when compared with caudal epidural in children undergoing primary hypospadias repair. Postoperative urethral fistula formation was more likely in children who received caudal epidural.
Authors: Brad M Taicher; Jonathan C Routh; John B Eck; Sherry S Ross; John S Wiener; Allison K Ross Journal: Paediatr Anaesth Date: 2017-03-27 Impact factor: 2.556
Authors: Patrick Pine Tanseco; Harkanwal Randhawa; Michael Erlano Chua; Udi Blankstein; Jin Kyu Kim; Melissa McGrath; Armando J Lorenzo; Luis H Braga Journal: Can Urol Assoc J Date: 2018-12-03 Impact factor: 1.862
Authors: Ruslan Abdullayev; Ulku Sabuncu; Öznur Uludağ; Hatice Selcuk Kusderci; Mesut Oterkus; Aysel Buyrukcan; Mehmet Duran; Mehmet Bulbul; Hasan Ogunc Apaydin; Nail Aksoy; Musa Abes Journal: Cureus Date: 2019-03-30