The analgesic effect of clonidine as an adjuvant in dorsal penile nerve block.
INTRODUCTION
Dorsal penile nerve block (DPNB) is a commonly performed regional anesthetic technique for male circumcision. The aim of this study was to assess the analgesic effect of the adjunction of clonidine to bupivacaine 0.5% in this block.


METHODS
It was a prospective randomized double-blind clinical trial including 40 ASA1 boys aged from 1 to 4 years undergoing elective circumcision. Dorsal penile nerve block was performed under general Anesthesia. Patients were randomized in two groups: Group 1 (G1): received 0.1 ml/Kg of bupivacaine 0.5% with 1µg/kg of clonidine in each side. Group 2 (G2): received 0.1 ml/kg of bupivacaine 0.5% with placebo in each side. The failure of the DNPB was defined by the increase of heart rate by more than 25% comparing to baseline and in his case an intravenous injection of 20 µg/kg of alfentanyl was given. Post-operative pain was assessed by CHEOPS score.


RESULTS
A total of 40 patients were enrolled. Demographic parameters were similar in both groups. We noted no case of DNPB failure in this study. The supply for additional analgesia was seen in 12 patients in group 2 versus 3 cases in group 1. CHEOPS (Children's Hospital of Eastern Ontario Pain Scale) was significantly lower in group 1 from 2nd post operative hour until the 24th hour.


CONCLUSION
Clonidine can be used in dorsal penile nerve block to improve and to prolong its analgesic effects after male circumcision.
['Anouar|Jarraya|J|', 'Mohamed|Smaoui|S|', 'Sofiene|Abidi|A|', 'Jawhar|Zouari|Z|', 'Sahar|Elleuch|E|', 'Kamel|Kolsi|K|']
D000700:Analgesics D000779:Anesthetics, Local D002045:Bupivacaine D002675:Child, Preschool D002944:Circumcision, Male D003000:Clonidine D004311:Double-Blind Method D006801:Humans D007223:Infant D008297:Male D009407:Nerve Block D010147:Pain Measurement D010149:Pain, Postoperative D010413:Penis D011446:Prospective Studies D060525:Pudendal Nerve
Dorsal penile nerve block circumcision postoperative pain