Ultrasound-Guided Dorsal Penile Nerve Block Reduces Perioperative Opioid Requirements in Pediatric Circumcision: A Systematic Review and Meta-Analysis.
Amani N Alansari, Marwa Messaoud, Mohamed Sayed Zaazouee et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effectiveness of ultrasound-guided versus landmark-based dorsal penile nerve block (DPNB) in reducing opioid requirements during pediatric circumcision. Analyzing data from nine studies involving 949 children, the results indicated that ultrasound-guided DPNB significantly decreased intraoperative opioid rescue (risk ratio 0.39) and postoperative opioid needs (risk ratio 0.26) compared to landmark techniques.
Key findings
- Ultrasound-guided DPNB reduced intraoperative opioid rescue requirements (risk ratio 0.39).
- Postoperative opioid requirements were significantly lower with ultrasound-guided DPNB (risk ratio 0.26).
- Procedural time was modestly longer for ultrasound-guided blocks (mean difference 1.48 min).
- No significant differences were found in pain scores, discharge time, or postoperative nausea/vomiting.
Why it matters
Reducing opioid use in pediatric patients is crucial for minimizing potential side effects and promoting safer recovery. This study suggests that ultrasound guidance in DPNB can effectively lower opioid requirements during circumcision, which may enhance patient care and outcomes.