Circumcision is one of the most commonly performed operations in the paediatric population
and is a painful procedure. Circumcision is performed with two popular techniques, Plastibell
and conventional dissection method. Two anesthetic techniques are commonly used for
intra-operative (OP) and post-OP pain relief i.e CB and DPNB+RB at the base of the penis.
Addition of dexmedetomidine to bupivacaine prolongs duration of analgesia of CB. Both
anaesthesia techniques of pain relief have certain advantages and disadvantages and the
superiority of any technique over the other has not been established.
There are very few randomized controlled trials comparing these two methods of intra-OP and
post-OP pain relief, for different surgical techniques of circumcision and there is a lack of
well-conducted studies comparing the quality of analgesia, need for rescue analgesia in the
early post-OP period, complications, and parental satisfaction comparing these blocks.
Furthermore, there is a lot of contradiction in the literature regarding the duration of
analgesia produced with these techniques.
Poorly treated postoperative pain leads to fatigue and metabolic, endocrine, and
immunological changes can lead to prolonged convalescence following surgery and is traumatic
to the pediatric patients and their parents. In this study, the investigators planned to
compare the two most popular methods of pain relief during and after circumcision, along with
parents' satisfaction.
This research will guide the anesthetists regarding the selection of appropriate techniques
of intra-OP and post-OP analgesia and in light of intra and post-OP data; and parents'
satisfaction.
In this prospective randomized study the investigators plan to compare the quality of intra
and post OP analgesia and the duration of post-OP analgesia produced by CB and DPNB +RB, need
of rescue analgesia with both of the techniques of surgery, intra-OP hemodynamic variations,
residual motor block, and adverse effects and parents' satisfaction with both of the
anesthesia and the surgical techniques.
Research Objectives:
To evaluate and compare the intra and post-OP pain relief under CB and DPNB plus RB in
pediatric patients undergoing circumcision with different surgical techniques and assessment
of parents' satisfaction
This study may guide the anesthetists for the selection of appropriate techniques of intra
and post-OP analgesia and their complications for different surgical techniques of
circumcision and also about parent's satisfaction with the anesthetic technique.