2026-10-13T11:57:45Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34045484 2026-10-01T11:47:43Z category_146 category_7 category_734 category_106 category_122 portal_87 item_type_3 month_year_10_2026

Ultrasound-Guided Dorsal Penile Nerve Block Reduces Perioperative Opioid Requirements in Pediatric Circumcision: A Systematic Review and Meta-Analysis Amani N. Alansari (19743643) Marwa Messaoud (22827959) Mohamed Sayed Zaazouee (10576593) Naser El-Mefleh (25156382) Surendra M. Chinnappa (25156385) Nabil A. Shallik (17877023) Space Science Medicine Biological Sciences not elsewhere classified Science Policy Mental Health Dorsal penile nerve block ultrasound-guided landmark-based pediatric circumcision regional anesthesia <p>This meta-analysis compares ultrasound-guided and landmark-based dorsal penile nerve block (DPNB) in pediatric circumcision.</p> <p>We systematically searched PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL from inception to December 2025. Eligible studies included randomized controlled trials (RCTs) and observational cohorts comparing ultrasound-guided with landmark-based DPNB in pediatric patients (≤18 years) undergoing circumcision. Primary outcomes were intraoperative and postoperative opioid rescue requirements. Secondary outcomes included pain scores at incision, surgical duration, discharge time, and postoperative nausea/vomiting. Meta-analyses were performed using RStudio version 4.4.3.</p> <p>Nine studies involving 949 children met inclusion criteria (five RCTs, four retrospective cohorts). Ultrasound-guided DPNB significantly reduced intraoperative opioid rescue (risk ratio 0.39, 0.18–0.88; <i>p</i> = 0.028) and postoperative opioid requirements (risk ratio 0.26, 0.07–0.94; <i>p</i> = 0.0442) compared with landmark-based techniques. No significant differences emerged in pain scores at incision, discharge time, or postoperative nausea/vomiting. Ultrasound-guided blocks required modestly longer procedural time (mean difference 1.48 min, 0.03–2.94; <i>p</i> = 0.048).</p> <p>Ultrasound-guided DPNB substantially may reduce perioperative opioid requirements in pediatric circumcision compared with landmark-based approaches, despite slightly longer procedural times. When resources and expertise permit, ultrasound guidance should be considered the technique of choice for optimizing opioid-sparing anesthesia in this population.</p> 2026-10-01T11:47:43Z Dataset Dataset 10.6084/m9.figshare.34045484.v1 https://figshare.com/articles/dataset/Ultrasound-Guided_Dorsal_Penile_Nerve_Block_Reduces_Perioperative_Opioid_Requirements_in_Pediatric_Circumcision_A_Systematic_Review_and_Meta-Analysis/34045484 CC BY 4.0