COMPARISON OF POST-OPERATIVE ANALGESIC EFFICACY OF CAUDAL BLOCK VERSUS DORSAL PENILE NERVE BLOCK WITH BUPIVACAINE AND TRAMADOL FOR CIRCUMCISION IN CHILDREN

BACKGROUND Circumcision is a painful intervention, frequently performed in paediatric surgery. We aim to compare the effects of penile block versus caudal block using bupivacaine with tramadol for circumcision to evaluate post-operative analgesia. MATERIALS AND METHODS This randomised controlled trial study was conducted on 60 healthy boys aged 1- 7 years of American Society of Anaesthesiologist (ASA) class-1, scheduled for circumcision under general anaesthesia. The patients were randomly divided into two equal groups: Group P (penile block, 0.25% bupivacaine with tramadol 1 mg/kg, 0.5 mL/kg, n= 30) and Group C (caudal block, 0.25% bupivacaine with tramadol 1 mg/kg, 0.5 mg/kg, n= 30). Post-operative pain is evaluated by the FLACC pain score and time to first rescue analgesic request as well as total doses of analgesic requirements were recorded. RESULTS The mean duration of analgesia was 22 +/- 4.45 hrs. in Group P, while in Group C it was 11 +/- 2.75 hrs. (p= 0.0001). No significant difference was observed in incidence of haemodynamic changes or no side effect observed. Total analgesic requirement was also significantly low in Group P than Group C. CONCLUSION DPNB (bupivacaine with tramadol) for circumcision provides longer post-operative analgesia than caudal (bupivacaine with tramadol) without significant increase in rate of adverse effect.