Version 1
: Received: 21 August 2023 / Approved: 22 August 2023 / Online: 23 August 2023 (07:10:23 CEST)
How to cite:
Coskun, I.; Yalcin, O. Is USG-assisted Caudal Block Adequate for Postoperative Analgesia in the Early Phase of Circumcision? Is Rescue Analgesia Necessary?. Preprints2023, 2023081604. https://doi.org/10.20944/preprints202308.1604.v1
Coskun, I.; Yalcin, O. Is USG-assisted Caudal Block Adequate for Postoperative Analgesia in the Early Phase of Circumcision? Is Rescue Analgesia Necessary?. Preprints 2023, 2023081604. https://doi.org/10.20944/preprints202308.1604.v1
Coskun, I.; Yalcin, O. Is USG-assisted Caudal Block Adequate for Postoperative Analgesia in the Early Phase of Circumcision? Is Rescue Analgesia Necessary?. Preprints2023, 2023081604. https://doi.org/10.20944/preprints202308.1604.v1
APA Style
Coskun, I., & Yalcin, O. (2023). Is USG-assisted Caudal Block Adequate for Postoperative Analgesia in the Early Phase of Circumcision? Is Rescue Analgesia Necessary?. Preprints. https://doi.org/10.20944/preprints202308.1604.v1
Chicago/Turabian Style
Coskun, I. and Onur Yalcin. 2023 "Is USG-assisted Caudal Block Adequate for Postoperative Analgesia in the Early Phase of Circumcision? Is Rescue Analgesia Necessary?" Preprints. https://doi.org/10.20944/preprints202308.1604.v1
Abstract
Introduction and Objective: Caudal block has been used in children for many years and is considered the gold standard for multimodal analgesia in the pediatric age group. Caudal block belongs to the category of central neuraxial blocks, which can provide both visceral and somatic analgesia. With the introduction of ultrasound into the clinical practice of anaesthesia, the caudal block is now performed under USG guidance. In our study, we aimed to compare the efficacy of a single caudal block in postoperative acute pain management, the need for additional analgesics, the incidence of side effects, the timing of initial analgesic administration, and the need for rescue analgesic administration (paracetamol 10 mg/kg) in circumcision surgery.
Materials and Methods: 120 patients undergoing circumcision surgery were divided into 3 groups. The caudal block was performed in all cases under USG guidance. Only the caudal block was applied for cases in the Caudal group (Group C). The Caudal + paracetamol group (Group CP) received paracetamol 10 mg/kg intravenously (i.v.) and the caudal block. Patients in the Caudal + meperidine group (Group CM) received 1 mg/kg meperidine intravenously. The caudal block was performed in each case with a 0.5 ml/kg volume of 0.125% bupivacaine.
Results: As a result of our study, it was found that the least postoperative pain occurred in 12.50% of the CM group (p=0.011). Significant results were obtained when weight and age variables were analyzed according to the groups (p-values p=0.011 and p=0.003, respectively). Significant differences were found between the input pulse values, 5-minute pulse values, 15-minute pulse values, and input SpO2 values (p values p < 0.001, p < 0.001, p=0.011, p=0.037, respectively). Only Wong-Baker pain scores at the 24th hour differed significantly from the periods measured after the groups (p < 0.001). There was no significant difference between the FLACC and Wong-Baker pain scores in the other periods. There was no difference between the groups regarding the time when postoperative analgesics were administered and the total amount of analgesics administered (rescue analgesic 10 mg/kg oral paracetamol) (p=0.408, p=0.238).
Conclusion: Caudal block can be safely applied during circumcision. Ultrasound guidance increases the chances of success and reduces the complication rate. Caudal block can be safely used in pediatric surgery since it does not cause serious complications, has low postoperative pain scores, and reduces the number of postoperative analgesics.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
