Caudal or Dorsal Nerve Block?

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Abstract
Boys (50) presenting for day case circumcision were allocated randomly to receive either caudal analgesia or dorsal nerve block (DNB) to provide postoperative pain relief. Analgesia was assessed by a single, unbiased observer utilising a 3-point scale. Parents completed a simple questionnaire. Subjects in the DNB group micturated earlier (P < 0.05) and stood unaided earlier (P < 0.025) than patients in the caudal group. The incidence of vomiting was significantly lower in the DNB group (P < 0.05). There was no significant different in the duration of analgesia, although that produced in the DNB group tended to wane sooner. DNB with bupivacaine provides satisfactory analgesia following circumcision and has specific advantages when compared with caudal analgesia.