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Comparison between Penile Block & Caudal Epidural Block in Children Undergoing Hypospadias Repair

مقارنة بين حصار القضيب و الحصار الذيلي في جراحة الإحليل التحتي عند الأطفال

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 Publication date 2012
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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intraoperative penile engorgement because of caudal epidural block may result in tension on surgical sutures and alter surgical outcome Aim & objective: to compare between the effect of penile block &caudal epidural block on the quality of analgesia & surgical outcome following hypospadias repair.

References used
Blaise G Roy WL , postoperative pain relief after hypospadias repair in pediatric patient : regional analgesia versus systemic analgesics .Anesthesiology 1986 ;65:84-86
SohCR.Ng SBA ,Lim SL .Dorsal penile nerve block . PaediatreAnaesth 2003 ;13: 329-333
CarlssonP.Svenson J. The duration of pain relief after penile block to boys undergoing circumcision .ActaAnaesthesiolScand 1984 ;28: 432-434
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Alleviating pain in children is one of the most exciting and rewarding of professional activities . pediatric regional anesthesia is receiving its deserved attention as an excellent technique for a balanced intraoperative anesthesia as well as post operative analgesia . Continuous caudal block provides adequate duration of analgesia, not only for lower limb and lower abdominal surgeries, but also for upper abdominal and thoracic surgery , conserving the haemodynamic stability .
chronic pain after inguinal hernia repair is an adverse outcome that affects about 12 % to 54 % of patients. Ilioinguinal and iliohypogastric ( IG – IH ) nerve block has been widely used in patients undergoing inguinal hernia repair. Ketorolac is indicated for the short term (less than 5 days)management of pain and appears to be particularly useful in the immediate postoperative period. A standard dose of Ketorolac provides analgesia equivalent to 6 – 12 mg of morphine administered by the same route. The interval to onset is also similar to morphine, but Ketorolac has a longer duration of action (6 – 8 h). what is the best method for pain management after inguinal procedures? Is there any difference between (IG – IH) nerve block, and Ketorolac IV postoperatively (pain scores, early movement, nausea, vomiting ...)?
The frequency of velopharyngeal insufficiency (VPI) after primary repair of cleft palate is very high, and in most cases it attributed to the short velum after the surgical repair of the cleft. This study aims to compare the distance between the v elum and the posterior wall of the pharynx in cleft children before and immediately after the surgery in comparison with healthy children. Materials and Methods: This study included 34.
The purposes of the present study were to determine the effectiveness of infiltration anesthesia in the mandibular primary molars compared with inferior alveolar nerve block, and how tooth location, and the type of treatment performed, and the vo lume of anesthetic solution relate to the quality of anesthesia. The study population consisted of ١١٦ cooperative children, ٣-٦ years old, requiring the same type of treatment on contralateral mandibular molars.
The common problem that may encounter surgeons were the change of the volume of iliac bone grafts which used in atrophic region in the alveolar bone because of the resorption of this grafts during healing period. This study aimed to compare between block graft which taken by surgical bur (trephine)and grafts which collected by bone scraper ,in this way the bone graft look like small chips .This study included 10 patients who presented the oral and maxillofacial department in dentistry faculty in Damascus university between 2010-2012 A.D. the patients suffered from sever atrophy in upper and lower alveolar bone for different underlying causes and needed to compromise these atrophy to create a suitable area for dental implantation .The iliac bone grafts were turned into a real bone in the grafted area but the block grafts were saving their volumes more than the grafts collected by bone scraper. We used Mann-Whitney U and SPSS to evaluate the data that collected during the research and the results revealed that the block iliac bone graft which used to compromise the atrophic region would resorb less than the grafts which collected by bone scraper . But these grafts showed that it would be more exposed after surgery than the bone scraper grafts .

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