[Subpubic block in superficial operations of peins]

ABSTRACT

Circumcision is the most common surgical procedure. As same as other superficial operations, they cause not only severe postoperative pain but also are accounted a severe intraoperative stimulation. There are many anesthetic techniques for circumcision. It seems supplementary penile block to general anesthesia is the best approach. Our aim in this study is to evaluate the efficacy of sub pubic approach to dorsal penile nerve block in relieving postoperative pain. This descriptive study was done in Dr Sheikh Pediatric Hospital during summer of 2004. Sub pubic approach to dorsal penile nerve block was evaluated in 60 boys. Two injections were performed with plain Bupivacaine 0.5%, 0.1 ml/kg in each side [total 0.2 ml/kg] at puncture sites, which had been marked before, just 0.5 to 1 cm blow pubic symphisis and lateral to midline in the supine position. Postoperative pain was evaluated with two methods, FLACC and Wong and Baker, and parental report up to 24 hours after general anesthesia. Collected data was analyzed by using descriptive and analytical statistics. Two cases [3.3%] were excluded. Two patients [3.4%] experienced moderate pain postoperatively. Others [96.5%] were completely pain free up to 24 hours after procedure. No complications occurred. There was no relationship between needle length and patients' age. According to this and previous studies, although there is little experience, this technique is the most successful and safe approach for intra and postoperative long [up to 24h] pain relief that with some experience is also very easy