Zeana Amer Gawe

Title : Comparison between the caudal block and other methods of postoperative pain relief in children undergoing circumcision: A prospective randomized study

Abstract:

Background: 
Caudal block (CB), dorsal nerve penile block (DPNB) and systemic opioids are common techniques used in pediatric surgeries to provide analgesia for penile surgery such as circumcision. This study aimed to compare the effectiveness of the CB with other methods of postoperative pain release.

Methods: 
This prospective, randomized, case-controlled trial was conducted in the main pediatric operation theater and post-anesthesia recovery unit (PACU). Successive children aged 3 months to 3 years who had American Society of Anesthesiologists Physical Status classification I and had undergone elective circumcision surgery were recruited. Children were randomized to one of 3 groups, CB (Group A), systemic opioids
(Group B), or DPNB (Group C). Patients were injected with 0.75 to 1 mL/kg 0.25% bupivacaine in group A, fentanyl 1-3 μg/kg in group B, and 0.3 mL/kg 0.25% bupivacaine in group C. The need for analgesia and parental satisfaction were assessed during the first 6 hours postoperatively. The Face, Leg, Activity, and Cry Consolability (FLACC) pain scale and behaviors were used to observe and compare the three groups.

Results: 
Participants’ heart rate was higher among group C, while it was the lowest in group A during the observation period (P<0.05). High pain, crying, movement, agitation, and posture scales were observed among
group C followed by group B, while group A showed the lowest scores. Patients who received penile block had expressed a longer time to achieve the “relaxed and comfortable” status but with no significant difference with the other two groups. Moreover, types of regional block were mainly the significant predictor of pain scale at 5, 10, 20, 30, and 60 minutes postoperative.

Conclusions: 
For postoperative pain management, the study has shown that CB is proven to produce higher levels of analgesia and a longer period of pain release compared to penile block, even if both methods help relieve pain during pediatric surgical procedures.

Keywords: Caudal; Pediatric; Penile block; Opioids; Circumcision; Postoperative analgesia

Biography:

Zeana Amer Gawe, MBBCH.MD, SABA. Specialist of anesthesia and ICU,More then 22years experience. Current work specialist of anesthesia in Anesthesia Department, IBN ALNAFEES Hospital, Manama, Bahrain. email [email protected] /[email protected] ORCIDnumber 0000-0001-6402-1685

Qualification :
Bachelor's degree in medical practice
Master in general anesthesia, intensive care,pain management since 2002
Arab Board in General Anesthesia and pain management

Previous work in Salmanyia medical complex as specialist of anesthesia and pain management and I was conducted the Research's on the pediatric anesthesia and pain relief intra and post operation and has been published and recorded in clinical trials.gov. Member of the Research Council

Academic Performance1-: Researchs
1- The Effect of Caudal Anesthesia Block on Perioperative Pain Control and Reduction of the Anesthetic Agent in Pediatric Infraumbilical Surgery: A Prospective Randomized Trial Study Zeana Amer Gawe1, Hasan Mohamed Isa2, Muatasem Mohamed Almashaur3, Fayza Haider4
DOI: 10.4103/aer.aer_64_22
Published in the journal Anesthesia essay and research ClinicalTrials.gov ID: NCT05581940
2-Comparison between the Caudal Block and Other Methods of Postoperative Pain Relief in Children
Undergoing Circumcision: A Prospective Randomized Study. ,Gawe ZA, Anesth Crit Care 2023

ClinicalTrials.gov ID: NCT06086106
DOI:10.26502/acc.063