TIMING OF DORSAL PENILE BLOCK FOR CIRCUMCISION DOES NOT AFFECT PERI-OPERATIVE NARCOTIC ADMINISTRATION

You have accessJournal of UrologyPediatrics: Hypospadias and Penile Surgery (MP65)1 Apr 2020MP65-09 TIMING OF DORSAL PENILE BLOCK FOR CIRCUMCISION DOES NOT AFFECT PERI-OPERATIVE NARCOTIC ADMINISTRATION Alexandra Rehfuss*, Rama Jayanthi, Seth Alpert, Daryl McLeod, Molly Fuchs, Christina Ching, and Daniel Dajusta Alexandra Rehfuss*Alexandra Rehfuss* More articles by this author , Rama JayanthiRama Jayanthi More articles by this author , Seth AlpertSeth Alpert More articles by this author , Daryl McLeodDaryl McLeod More articles by this author , Molly FuchsMolly Fuchs More articles by this author , Christina ChingChristina Ching More articles by this author , and Daniel DajustaDaniel Dajusta More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000940.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Dorsal penile nerve block at the time of penile surgery helps with perioperative pain control. Our goal was to determine if performing the nerve block before the procedure provided better pain control than performing the block at the end of the procedure. Our hypothesis was that penile nerve block prior to penile surgery would result in less peri-operative narcotic use. METHODS: We performed a prospective randomized controlled trial of males 3 years of age and younger undergoing circumcision or circumcision revision in the operating room under general anesthesia. Patients were randomized to penile nerve block before incision or at the conclusion of the procedure. Penile nerve block was performed with 0.25% Marcaine (1ml/kg if <10kg, 10ml if >10kg) and anesthesiologists were blinded to timing of block administration. Intraoperative and post-anesthesia care unit (PACU) medication administration was recorded, as well as pain scores in the PACU. RESULTS: Fifty patients were enrolled and 25 patients were randomized to penile block before and 25 patients to penile block after circumcision or circumcision revision. Both groups were similar, and the results are shown in the table. There was no difference between the two groups in narcotic administration intra-operatively, in PACU, or overall. There was no difference in PACU pain scores between the two groups. In the before group, 2 patients received no intraoperative narcotics, but both received narcotics in PACU. In the after group, 3 patients received no intraoperative narcotics, and only 1 of these patients received narcotics in PACU. Less than half of patients received non-narcotic pain medications. CONCLUSIONS: Penile nerve block before circumcision or circumcision revision does not decrease perioperative narcotic use when compared to nerve block at the end of the procedure. This may be explained by the short operative time for these procedures and the quick onset of action of Marcaine. Increased use of non-narcotic pain medications may reduce perioperative narcotic use. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e976-e977 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexandra Rehfuss* More articles by this author Rama Jayanthi More articles by this author Seth Alpert More articles by this author Daryl McLeod More articles by this author Molly Fuchs More articles by this author Christina Ching More articles by this author Daniel Dajusta More articles by this author Expand All Advertisement PDF downloadLoading ...