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Caudal epidural block versus other methods of postoperative pain relief for circumcision in boys

Overview of attention for article published in Cochrane database of systematic reviews, October 2008
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Title
Caudal epidural block versus other methods of postoperative pain relief for circumcision in boys
Published in
Cochrane database of systematic reviews, October 2008
DOI 10.1002/14651858.cd003005.pub2
Pubmed ID
Authors

Allan M Cyna, Philippa Middleton

Abstract

Techniques to minimize the postoperative discomfort of penile surgery, such as circumcision, include caudal block; penile block; systemic opioids and topical local anaesthetic cream, emulsion or gel. To compare the effects of caudal epidural analgesia with other forms of postoperative analgesia following circumcision in boys. We searched CENTRAL (The Cochrane Library 2008, Issue 1), MEDLINE (to April 2008) and EMBASE (to April 2008). Randomized and quasi-randomized trials of postoperative analgesia by caudal epidural block compared with non-caudal analgesia in boys, aged between 28 days and 16 years, having elective surgery for circumcision. Two review authors independently carried out assessment of study eligibility, data extraction and assessment of the risk of bias in included studies. We included 10 trials involving 721 boys. No difference was seen between caudal and parenteral analgesia in the need for rescue or other analgesia (relative risk (RR) 0.41, 95% confidence interval (CI) 0.12 to 1.43; 4 trials, 235 boys; random-effects model) or on the incidence of nausea and vomiting (RR 0.61, 95% CI 0.36 to 1.05; 4 trials, 235 boys). No difference in the need for rescue or other analgesia was seen for caudal compared with dorsal nerve penile block (DNPB) (RR 1.25, 95% CI 0.64 to 2.44; 4 trials, 336 boys; random-effects model). No differences were seen between caudal block and DNPB in the incidence of nausea and vomiting (RR 1.88, 95% CI 0.70 to 5.04; 4 trials, 334 boys; random effects model) or individual complications except for motor block (RR 17.00, 95% CI 1.01 to 286.82; 1 trial, 100 boys) and motor or leg weakness (RR 10.67, 95% CI 1.32 to 86.09; 2 trials, 107 boys). These were significantly more common in the caudal block groups than with DNPB. No differences were seen between caudal and rectal or intravenous analgesia in the need for rescue analgesia or any other outcomes (2 trials, 162 boys). Differences in the need for rescue or other analgesia could not be detected between caudal, parenteral and penile block methods. In day-case surgery, penile block may be preferable to caudal block in children old enough to walk due to the possibility of temporary leg weakness after caudal block. Evidence from trials is limited by small numbers and poor methodology. There is a need for properly designed trials comparing caudal epidural block with other methods such as morphine, simple analgesics and topical local anaesthetic creams, emulsions or gels.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 123 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
United States 1 <1%
Australia 1 <1%
Egypt 1 <1%
Unknown 119 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 21 17%
Student > Master 16 13%
Student > Doctoral Student 11 9%
Other 11 9%
Student > Postgraduate 10 8%
Other 34 28%
Unknown 20 16%
Readers by discipline Count As %
Medicine and Dentistry 56 46%
Nursing and Health Professions 10 8%
Psychology 8 7%
Agricultural and Biological Sciences 8 7%
Biochemistry, Genetics and Molecular Biology 4 3%
Other 13 11%
Unknown 24 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 August 2020.
All research outputs
#10,389,944
of 16,276,344 outputs
Outputs from Cochrane database of systematic reviews
#9,813
of 11,460 outputs
Outputs of similar age
#149,537
of 269,301 outputs
Outputs of similar age from Cochrane database of systematic reviews
#154
of 184 outputs
Altmetric has tracked 16,276,344 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 11,460 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 24.0. This one is in the 9th percentile – i.e., 9% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 269,301 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 35th percentile – i.e., 35% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 184 others from the same source and published within six weeks on either side of this one. This one is in the 13th percentile – i.e., 13% of its contemporaries scored the same or lower than it.