Ultrasound-guided penile block for circumcision instead of anatomical landmark method in newborn babies

Abstract

Background: The primary objective of this study is to compare the effectiveness of the newborn's penile block performed by the surgeon using the classical landmark method and the penile block performed by the anesthesiologist with ultrasound guidance. Results: This prospective, single-blinded, randomized clinical study included a total of forty newborn babies scheduled to undergo elective circumcision. The babies were randomized into two treatment groups of ultrasound (US)-guided penile block (group I

n = 20) and classical landmark method dorsal penile nerve block (DPNB) (group II

n = 20) group. Face, Legs, Activity, Cry, Consolability (FLACC) score was used to determine the block efficacy and postoperative pain and analgesic requirements. Intraoperative and postoperative FLACC scores, intraoperative analgesic needs, discharge time, complications, first oral intake time, and parent's satisfaction were also recorded. FLACC scores were higher in group II than in group I during the intraoperative periods. Heart rate was higher in group II than in group I, at the incision, and during the procedure (P < 0.05). The number of patients requiring fentanyl was higher in group II than in group I (P < 0.01). FLACC scores were statistically higher in the landmark group at arrival in the PACU (P < 0.01) and after 30 min up to 2 h (P < 0.01). Parent's satisfaction was significantly higher in US group (P < 0.01) Conclusions: Intraoperative analgesic needs and pain scores are lower in newborn babies who performed penile block with ultrasound-guided compared to the landmark method.