Dorsal Penile Block Versus Placebo for Circumcision in Low Birthweight Neonates. • 1281

A video study of pain relief during newborn male circumcision

“…No complications occurred secondary to the anesthetic method used (hematoma, rash, skin sloughing, urinary retention, or seizures). 9 The median Neonatal Infant Pain Scale scores were significantly lower in the dorsal penile nerve block group than in the topical lidocaine-prilocaine group or the sham group (1.0 (range 0-6) versus 6.0 (range 2-6) versus 4.0 (range 0-6), P<0.001, respectively) ( Table 1). The mean numeric pain scale scores were also significantly lower in the dorsal penile nerve block group than in the topical lidocaine-prilocaine group or the sham group The reviewer characteristics, when compared by medical background, were similar with respect to age, gender, parental status, and prior male child circumcised ( Table 2).…”

“…3 Topical lidocaine-prilocaine should be abandoned as the primary method of pain relief for circumcision since dorsal penile nerve block is a more effective anesthetic as shown by our study and several others. [7][8][9][10] The combination of topical lidocaine-prilocaine with dorsal penile nerve block has been shown to be safe with less pain than topical lidocaine-prilocaine alone. 14 The utilization of topical lidocaine-prilocaine cream at the base of the penis prior to injection to reduce injection site pain during dorsal penile nerve blockade seems sensible, but has only been studied in older children undergoing circumcision.…”

“…These behavioral components have been videotaped for the investigators to complete analysis. [7][8][9][10][11][12][13][14] Video studies have only been reviewed by the study investigators and never reviewed by noninvestigators or by nonmedical persons. In addition, no studies have used sham procedures in comparing anesthesia techniques or evaluate baseline levels of pain.…”