Selected abstracts from the Annual Meeting, Society of Paediatric Anaesthetists in New Zealand and Australia (SPANZA). Held 6-9 November 2008 in the Hunter Valley, NSW, Australia Abstracts

Postoperative analgesia for male circumcision surgery has been traditionally provided by a landmark based Dorsal Penile Nerve Block (DPNB-LM) (1) or by Caudal Epidural Analgesia (CEA). In this study we report on a retrospective analysis of the effectiveness and safety of CEA, DPNB-LM and Dorsal Penile Nerve block - Ultrasound guided (DPNB-US) in our institution over a 6 year period. Information was gathered from each patient's medical record. A total of 216 circumcisions were performed on patients aged from 5 months to 15 years. A total of 115 patients received CEA, 46 DPNB-LM and 55 DPNB-LM. Patients in the DPNB-LM group required rescue morphine administration in the Recovery unit more frequently (30.4%) than either the DPNB-US (3.5%) or CEA groups (3.6%). Similarly, the DPNB-LM group required a larger total dose of morphine, and had longer recovery ward stays than CEA or DPNB-US groups. Time to first analgesia was greatest for the CEA group whilst there was no significant difference between time to first analgesia for DPNB-LM and DPNB-US. About 63% of patients in the DPNB-LM group, 1.7% of CEA and 5.5% of the DPNB-US required intraoperative opiates (P < 0.0001). There was no difference in time to hospital discharge.