REGIONAL ANESTHESIA FOR CIRCUMCISION - SUBCUTANEOUS RING BLOCK OF THEPENIS AND SUBPUBIC PENILE BLOCK COMPARED

In this prospective study techniques for the subcutaneous ring block o f the penis and subpubic block of the penis for analgesia after circum cision were compared. Forty-five boys having circumcision as daycase p atients were allocated randomly to have either a subcutaneous ring blo ck or a subpubic penile block. The blocks were inserted after inductio n of anaesthesia but before surgery. Pain scores at 15, 30, 45 and 60 min post-operatively were recorded. Side effects and analgesic require ments in hospital were recorded post-operatively. Analgesia (morphine, paracetamol or diclofenac) was given depending on the pain score. One patient was withdrawn from the study. Four of the 24 boys who had sub pubic penile blocks and nine of the 16 boys who had subcutaneous ring blocks were given morphine for post-operative pain (P = 0.015). The su rgeons complained about oedematous tissues in three patients, all of w hom had had subcutaneous ring blocks. The subpubic penile block provid ed significantly better analgesia than the subcutaneous ring block of the penis.