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Paediatric Circumcision with Intravenous (IV) Ketamine, and Penile Block as a Day Care Surgery

Shabeeh Nazar, Associate Professor, Department of Surgery, Chirayu Medical College and Hospital Bhopal Madhya Pradesh 462030, India. , Roshan Chanchlania , Shabeeh Nazarb , G. Chavanc , Somya Jaind

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New Indian Journal of Surgery 9(1):p 54-56, Jan-Feb 2018. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9118.10

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Abstract

Background: Pediatric Circumcision is a common surgical procedure performed all over our country. Penile block is very useful for post operative analgesia in circumscion.Using penile block with Intravenous ketamine and midazolam patients can be managed smoothly without any major complication and it is a costeffective technique in pediatrics patients.

Aim: of this study is to evaluate the role of Intravenous (IV) Ketamine, and Penile Block in children undergoing circumscion.

Materials and Methods: This is an observational prospective study carried out in Department of surgery and Anesthesia Chirayu Medical college and hospital Hospital during the period from January 2011 to December 2016.During this period total 120 cases of circumcision were done. Children with American Society of Anesthesiologists (ASA) Grades I & II, between 15 days and 15 years of age were selected for this study. Patient was sedated using Ketamine 1 mg/kg plus midazolam 0.1 mg/kg and penile nerve block was given prior to circumscion with 1.5mg/kg lidocaine 2% mixed with 0.5mg/kg bupivacaine 0.5% without epinephrine to a maximum dose of 5 ml using a fine 26 guage needle. Close observation and monitoring was done clinically as well as with the help of pulse oximeter and sphygmomanometer.

Results: Among 120 patients ,11 patients had complications subcutaneous hematoma was seen in 5 cases . Partial block was observed in 2 cases,.There was transient fall in spo2 seen in 2 patients and cough and breathing difficulty in 2 patients.

Conclusion: Circumcision with low dose intravenous Ketamine and with penile block is a safe and costeffective anesthetic technique in children in a day care setting.

 

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9118.10

Keywords

Bupivacaine; Circumcision; Ketamine; Penile Block. 

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