BACKGROUND: Circumcision is a commonly performed surgical procedure in @entity1 and caudal @entity1337 is frequently used to minimize discomfort of penile surgery postoperatively. For humanitarian and physiological @entity158 should be anticipated and effectively controlled while ensuring @entity1 safety. Several non-caudal analgesic techniques can be used including: @entity546 , systemic opioids and topical local anaesthetic cream,emulsion or gel. OBJECTIVES: To compare the relative efficacy and side effects of caudal epidural @entity1337 with other forms of postoperative @entity1337 following circumcision in @entity1 . SEARCH STRATEGY: CENTRAL, MEDLINE (from 1966), and EMBASE are searched using MeSH headings: Circumcision, Anesthesia-Caudal, Pediatric or @entity1 , and the text words circumcision and caudal. Bibliographies of published trials and conference proceedings are also reviewed. Date of last search: December 2002. SELECTION CRITERIA: Published randomized and quasi-randomized controlled trials in which postoperative @entity1337 by caudal epidural block is compared with a non-caudal method of @entity1337 , in @entity1 whose mean age is between 28 days and 16 years, having elective surgery for circumcision. DATA COLLECTION AND ANALYSIS: Trials identified from searching are assessed for inclusion and data extracted independently by two reviewers. Review Manager software is used for calculation of the treatment effect, represented by relative risks (RR), using a fixed effects model with 95% Confidence Intervals (CI). MAIN RESULTS: Seven trials of average quality involving 374 @entity1 are included in this review. Only two comparisons of caudal @entity1337 have been investigated; parenteral analgesics in six trials, and @entity546 in one trial. Although some trial heterogeneity is evident this does not reach statistical significance. The need for rescue @entity1337 is reduced when caudal @entity1337 is compared with parenteral medications,((RR 0.32(0.16,0.63)). The incidence of @entity390 and @entity391 is decreased in caudal @entity1 compared with those receiving parenteral analgesics (RR 0.57 (0.35-0.93)) but not with those receiving @entity546 . REVIEWER'S CONCLUSIONS: Few studies compare caudal @entity1337 with other commonly available methods of @entity1337 in @entity1 having circumcision surgery. Although the need for rescue @entity1337 is reduced in the early postoperative period when caudal is compared with parenteral @entity1337 ,evidence from trials may no longer reflect current practice and is limited by small numbers and poor methodology. There is a need for properly designed trials to study the relative efficacy of caudal epidural with other methods such as @entity546 , @entity1286 , simple analgesics and topical local anaesthetic cream,emulsions or gel.

Caudal epidural block versus other methods of postoperative @entity158 relief for circumcision in XXXX .

@entity1 :: ('9606', 'Species') :: ['Child', 'patients', 'patient', 'boys'] @entity390 :: ('MESH:D009325', 'Disease') :: ['nausea'] @entity1337 :: ('MESH:D000699', 'Disease') :: ['analgesia'] @entity391 :: ('MESH:D014839', 'Disease') :: ['vomiting'] @entity158 :: ('MESH:D010146', 'Disease') :: ['reasons pain'] @entity1286 :: ('MESH:D009020', 'Chemical') :: ['morphine'] @entity546 :: ('MESH:D004414', 'Disease') :: ['penile block']
@entity1 :: (9606,Species) :: ['boys']
