PDF(Pubmed)
Abstract：
UNASSIGNED: Worldwide, one of the most common surgical procedures in the pediatric population is circumcision. There is no consent on the best anesthesiologic approach. This study aimed to investigate ultrasound-guided dorsal penile nerve block (DPNB) plus sedation in spontaneous breathing as a time-saving, safe, effective, and opioid-sparing technique.
UNASSIGNED: The primary outcome was the assessment of the time from the end of surgery and the discharge to the post-anesthesia care unit. Secondary outcomes were to evaluate the cumulative dosages of opioids, differences in pain levels between the two groups, and complications at the awakening, 4 h and 72 h after surgery, respectively.
UNASSIGNED: This was a prospective study with a retrospective control group, approved by the Friuli-Venezia Giulia Ethics Committee. Children in the intervention group received an ultrasound-guided DPNB under sedation and spontaneous breathing. With the probe positioned transversally at the base of the penis using an in-plane approach with a modified technique, local anesthetic was injected under the deep fascia of the penis.
UNASSIGNED: We recruited 70 children who underwent circumcision at the University Hospital of Udine, Italy, from 1 January 2016 to 1 October 2021: 35 children in the ultrasound-guided DPNB group and 35 children in the control group. Children who received ultrasound-guided DPNB had a statistically significant lower time to discharge from the operating room, did not require mechanical ventilation, maintained spontaneous breathing at all times, received fewer opioids, had lower mean intraoperative arterial pressures, and lower pain levels immediately after surgery.
UNASSIGNED: Ultrasound-guided DPNB associated with sedation and spontaneous breathing is a time-saving, opioid-sparing, safe, and effective strategy for the management of intraoperative and postoperative pain in children undergoing circumcision.Clinical trial registration: ClinicalTrial.gov (NCT04475458, 17 July 2020).
UNASSIGNED: The primary outcome was the assessment of the time from the end of surgery and the discharge to the post-anesthesia care unit. Secondary outcomes were to evaluate the cumulative dosages of opioids, differences in pain levels between the two groups, and complications at the awakening, 4 h and 72 h after surgery, respectively.
UNASSIGNED: This was a prospective study with a retrospective control group, approved by the Friuli-Venezia Giulia Ethics Committee. Children in the intervention group received an ultrasound-guided DPNB under sedation and spontaneous breathing. With the probe positioned transversally at the base of the penis using an in-plane approach with a modified technique, local anesthetic was injected under the deep fascia of the penis.
UNASSIGNED: We recruited 70 children who underwent circumcision at the University Hospital of Udine, Italy, from 1 January 2016 to 1 October 2021: 35 children in the ultrasound-guided DPNB group and 35 children in the control group. Children who received ultrasound-guided DPNB had a statistically significant lower time to discharge from the operating room, did not require mechanical ventilation, maintained spontaneous breathing at all times, received fewer opioids, had lower mean intraoperative arterial pressures, and lower pain levels immediately after surgery.
UNASSIGNED: Ultrasound-guided DPNB associated with sedation and spontaneous breathing is a time-saving, opioid-sparing, safe, and effective strategy for the management of intraoperative and postoperative pain in children undergoing circumcision.Clinical trial registration: ClinicalTrial.gov (NCT04475458, 17 July 2020).
摘要：
■全球，在儿科人群中最常见的外科手术之一是包皮环切术。没有关于最佳麻醉方法的同意。本研究旨在探讨超声引导下阴茎背神经阻滞（DPNB）加镇静在自主呼吸中的节省时间，安全,有效,和阿片类药物节省技术。
■主要结果是评估从手术结束到出院到麻醉后监护病房的时间。次要结果是评估阿片类药物的累积剂量，两组之间疼痛水平的差异，和觉醒时的并发症，手术后4h和72h，分别。
■这是一项回顾性对照组的前瞻性研究，由Friuli-VeneziaGiulia道德委员会批准。干预组的儿童在镇静和自主呼吸下接受超声引导的DPNB。使用改良技术的平面内方法将探针横向定位在阴茎的底部，在阴茎深筋膜下注射局部麻醉药。
■我们招募了70名在乌迪内大学医院接受包皮环切术的儿童，意大利,2016年1月1日至2021年10月1日:超声引导DPNB组35名儿童,对照组35名儿童.接受超声引导的DPNB的儿童从手术室出院的时间具有统计学上的显着降低，不需要机械通气，始终保持自主呼吸，接受更少的阿片类药物，术中平均动脉压较低，并在手术后立即降低疼痛水平。
■与镇静和自主呼吸相关的超声引导DPNB可以节省时间，保留阿片类药物，安全,以及治疗包皮环切术患儿术中和术后疼痛的有效策略。临床试验注册：ClinicalTrial.gov（NCT04475458，2020年7月17日）。
■主要结果是评估从手术结束到出院到麻醉后监护病房的时间。次要结果是评估阿片类药物的累积剂量，两组之间疼痛水平的差异，和觉醒时的并发症，手术后4h和72h，分别。
■这是一项回顾性对照组的前瞻性研究，由Friuli-VeneziaGiulia道德委员会批准。干预组的儿童在镇静和自主呼吸下接受超声引导的DPNB。使用改良技术的平面内方法将探针横向定位在阴茎的底部，在阴茎深筋膜下注射局部麻醉药。
■我们招募了70名在乌迪内大学医院接受包皮环切术的儿童，意大利,2016年1月1日至2021年10月1日:超声引导DPNB组35名儿童,对照组35名儿童.接受超声引导的DPNB的儿童从手术室出院的时间具有统计学上的显着降低，不需要机械通气，始终保持自主呼吸，接受更少的阿片类药物，术中平均动脉压较低，并在手术后立即降低疼痛水平。
■与镇静和自主呼吸相关的超声引导DPNB可以节省时间，保留阿片类药物，安全,以及治疗包皮环切术患儿术中和术后疼痛的有效策略。临床试验注册：ClinicalTrial.gov（NCT04475458，2020年7月17日）。
