Cochrane Summaries

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In boys having circumcision the need for additional (rescue) analgesia is similar whether caudal or penile block is used

Cyna AM, Middleton P
Published Online: 
10 November 2010

Postoperative pain following circumcision frequently results in crying, restlessness and agitation that may be associated with an increased incidence of bleeding. Therefore, pain needs to be anticipated and effectively controlled. Caudal epidural block is performed with the patient partly prone or on his side. It is one of the most common local anaesthetic techniques used in children. When compared with penile block, the need for rescue analgesia was similar. For boys old enough to walk, penile block may be preferable to caudal block since caudal block may cause temporary leg weakness. No difference in the need for rescue analgesia was seen when caudal block was compared with parenteral opioid (by injection). Other methods such as simple analgesics and topical local anaesthetics (creams and gels) have not been adequately evaluated and need to be compared with caudal block.

This record should be cited as: 
Cyna AM, Middleton P. Caudal epidural block versus other methods of postoperative pain relief for circumcision in boys. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD003005. DOI: 10.1002/14651858.CD003005.pub2
Assessed as up to date: 
14 April 2008