Clinical trial · Interventional
Caudal Block Versus Dorsal Penile Nerve Block Plus Ring Block for Pain Management of Different Surgical Techniques of Circumcision in Infants and Children
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Circumcision is one of the most commonly performed operations in the pediatric population and is a painful procedure. Circumcision is performed with two popular techniques, Plastibell and conventional dissection method (CDM). For intra-operative (OP) and post-OP pain relief, two commonly used local anesthetic techniques are caudal block (CB) and dorsal penile block (DPNB) plus ring block (RB) at the base of the penis. There are very few randomized controlled trials comparing these two methods of intra-OP and post-OP pain relief, for different surgical techniques and there is a lack of well-conducted studies comparing the quality of analgesia, need for rescue analgesia in the early post-OP period, complications, and parental satisfaction comparing these blocks. Furthermore, there is a lot of contradiction in the literature regarding the duration of analgesia produced with these techniques.
Conditions
Conditions (6)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Analgesia | — | UNRESOLVED | — |
| Anesthesia | — | UNRESOLVED | — |
| Anesthesia, Local | — | UNRESOLVED | — |
| Pain, Acute | — | UNRESOLVED | — |
| Pain, Postoperative | — | UNRESOLVED | — |
| Pediatric ALL | Childhood Acute Lymphoblastic Leukemia | ALIAS | 0.90 |
Interventions
Interventions (4)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Caudal block | Drug | — | UNRESOLVED |
| Circumcision with Plastibell | Procedure | — | UNRESOLVED |
| Conventional Dissection Method | Procedure | — | UNRESOLVED |
| Dorsal penile nerve block plus ring block | Drug | — | UNRESOLVED |
Design
Arms and outcomes
Arms (4)
- type
- EXPERIMENTAL
- label
- Caudal block and circumcision with Plastibell,
- description
- Caudal block will be performed with 0.75ml/kg of 0.25% bupivacaine containing 1 mic/kg dexmedetomidine. Circumcision will be done using plastibell. Paracetamol suppository will also be inserted per rectum in the dose of 15 mg/kg before the start of surgery. The surgery will be started 10 minutes after block placement to allow adequate time for the block to be effective.
- interventionNames
- Drug: Caudal block
- Procedure: Circumcision with Plastibell
- type
- EXPERIMENTAL
- label
- Caudal block and circumcision with conventional dissection method
- description
- Caudal block will be performed with 0.75ml/kg of 0.25% bupivacaine containing 1 mic/kg dexmedetomidine. Circumcision will be done using the conventional dissection method. Paracetamol suppository will also be inserted per rectum in the dose of 15 mg/kg before the start of surgery. The surgery will be started 10 minutes after block placement to allow adequate time for the block to be effective.
- interventionNames
Eligibility
Eligibility (as posted)
- Sex
- Male
- Minimum age
- 3 Months
- Maximum age
- 4 Years
Show eligibility criteria text
Inclusion Criteria: 1. Healthy, 2. Male, 3. Ages 3 months to 4 years, 4. Scheduled for circumcision for various indications under GA. Exclusion Criteria: 1. Patients with bleeding or clotting disorders 2. Patients with hypospadias, other penile or sacral anomalies 3. Patients weight \<3kg. 4. Allergy to Local Anesthetic 5. Infection at the site of block 6. Pre-existing spinal or neurological disease 7. Pain medication within the previous 48 hours
References
Publications (26)
- BACKGROUNDRossi S, Buonocore G, Bellieni CV. Management of pain in newborn circumcision: a systematic review. Eur J Pediatr. 2021 Jan;180(1):13-20. doi: 10.1007/s00431-020-03758-6. Epub 2020 Aug 3. PMID 32748017
- BACKGROUNDBawazir OA. A controlled trial of Gomco versus Plastibell for neonatal circumcisions in Saudi Arabia. Int J Pediatr Adolesc Med. 2020 Sep;7(3):132-135. doi: 10.1016/j.ijpam.2019.03.002. Epub 2019 Mar 21. PMID 33094142
- BACKGROUNDJiang ZL, Sun CW, Sun J, Shi GF, Li H. Subcutaneous tissue-sparing dorsal slit with new marking technique: A novel circumcision method. Medicine (Baltimore). 2019 Apr;98(16):e15322. doi: 10.1097/MD.0000000000015322. PMID 31008987
- BACKGROUNDWeksler N, Atias I, Klein M, Rosenztsveig V, Ovadia L, Gurman GM. Is penile block better than caudal epidural block for postcircumcision analgesia? J Anesth. 2005;19(1):36-9. doi: 10.1007/s00540-004-0287-8. PMID 15674514
- BACKGROUNDSoltany S, Ardestanizadeh A. The study of the factors affecting the time of ring fall off in circumcision using Plastibell. J Family Med Prim Care. 2020 Jun 30;9(6):2736-2740. doi: 10.4103/jfmpc.jfmpc_1261_19. eCollection 2020 Jun. PMID 32984117
- BACKGROUNDO'Sullivan MJ, Mislovic B, Alexander E. Dorsal penile nerve block for male pediatric circumcision--randomized comparison of ultrasound-guided vs anatomical landmark technique. Paediatr Anaesth. 2011 Dec;21(12):1214-8. doi: 10.1111/j.1460-9592.2011.03722.x. PMID 22023417
- BACKGROUNDWang X, Dong C, Beekoo D, Qian X, Li J, Shang-Guan WN, Jiang X. Dorsal Penile Nerve Block via Perineal Approach, an Alternative to a Caudal Block for Pediatric Circumcision: A Randomized Controlled Trial. Biomed Res Int. 2019 Mar 27;2019:6875756. doi: 10.1155/2019/6875756. eCollection 2019.