Circumcision surgery: Dorsal penile block or caudal block?

Objective: To investigate whether dorsal penile block and caudal block, applied in patients undergoing circumcision surgery, serve as alternative, safe, and effective methods to provide analgesia in the postoperative period and reduce opioid consumption; and to determine if either method has any superiority over the other. Materials and Methods: In our study, 90 patient files of individuals aged between 3 to 14 years who underwent circumcision surgery at the Department of General Surgery, Celal Bayar University Faculty of Medicine in 2022, were retrospectively reviewed. During file screening, patient follow-up forms, which were regularly recorded and included data on dorsal penile block and caudal block as postoperative analgesia techniques under general anesthesia, were selected. After screening, 60 patient files were included in the study. Patient demographic data such as age, height, weight, as well as OAB (overactive bladder) at postoperative 1st, 3rd, and 6th hours, heart rate, SpO2, respiratory rate, comfort scores of parents, anesthetists, patients, and surgeons, VAS values, and presence of analgesia requirement were recorded on the forms and divided into two groups according to the block type. The data were evaluated by the Celal Bayar University Statistics Department. Results: Patients were divided into two groups as Caudal Block (Group K, n=30) and Dorsal Penile Block (Group D, n=30) in terms of postoperative analgesic method preference. Age, weight, height measurements, and block application time were found to be higher in Group K except for surgical duration. There was no statistically significant difference between both block groups regarding postoperative VAS scores, initial analgesic needs, postoperative hemodynamic data, and comfort scores of patients, parents, surgeons, and anesthetists. Conclusion: In our study, we concluded that the caudal block and dorsal penile block we applied for postoperative analgesia in children undergoing circumcision surgery were not superior to each other in terms of analgesic efficacy and satisfaction of parents, patients, anesthetists, and surgeons. We believe that both CB and DPNB are alternative, safe, and effective methods to provide analgesia and reduce opioid consumption in patients undergoing circumcision surgery. However, due to the limited number of patients and clinical studies in the literature, it is concluded that an increase in patient and study numbers is necessary.