Pain control in neonatal male circumcision: A best evidence review

Labban, Muhieddine; Menhem, Zahraa; Bandali, Tarek; Hneiny, Layal; Zaghal, Ahmad

doi:10.1016/j.jpurol.2020.09.017

Cited by 14 publications

(20 citation statements)

References 45 publications

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“…Pain was not only the most frequently reported but also the most challenging AE to assess in infants. We chose to use NIPS to minimise providers' subjectivity; 29 however, this scale has only been validated for assessing acute pain in neonatal intensive care units and not in surgical settings. Although most of the severe AEs were due to an intraoperative NIPS score above 5, none of these infants required further analgesic intervention.…”

Section: Discussionmentioning

confidence: 99%

ShangRing versus Mogen clamp for early infant male circumcision in eastern sub-Saharan Africa: a multicentre, non-inferiority, adaptive, randomised controlled trial

Basourakos¹,

Nang²,

Ballman³

et al. 2022

The Lancet Global Health

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Section: Discussionmentioning

confidence: 99%

ShangRing versus Mogen clamp for early infant male circumcision in eastern sub-Saharan Africa: a multicentre, non-inferiority, adaptive, randomised controlled trial

Basourakos¹,

Nang²,

Ballman³

et al. 2022

The Lancet Global Health

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“…These studies have stated that patients may feel pain despite local anesthetic interventions. During the preparation of this publication, there were 9 studies on circumcision in Pubmed in 2021, 5 of which focused on pain (6)(7)(8)(9)(10)(11)(12) .…”

Section: Discussionmentioning

confidence: 99%

Dünya Çocuk Cerrahlarının Sünnette EMLA® Krem ile Oluşturulan Lokal Anestezi Hakkındaki Görüşleri Nedir?

Akman¹

2021

Tcdd

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Objective: Studies on neonatal pain are ongoing. Complications regarding the physiology of neonates, low GFR rate, limited drug use, methemoglobinemia, which is not found in other age groups lead to the search for safe drugs for painless operation. The idea that neonates do not feel pain has come to avoid pain caused by injection today. Therefore, EMLA® Cream, which is known to be effective with topical application, has become popular. Our study aims to reveal how the cream, which its analgesic effect is still doubted, is used by pediatric surgeons and to determine its common usage principles. Methods: Many surgeons from every continent and many different countries were contacted via e-mail. The questionnaire, with few questions and limited choices, was completed by the physicians. The participants were kept anonymous and interaction among them was prevented. Upon 10% returns from the e-mails sent, the questionnaire was terminated and subjected to basic evaluation. Results: The survey was completed in 107 women and 238 men, 345 participants. The results showed that 82 participants circumcised only using the cream and 91 surgeons who did not use the cream could use it in the future. The results also showed that 74.78% of the participants who avoided the cream had doubts about its pain prevention impact. The rate of avoidance of cream due to fatal side effects was 3.76%. According to the accommodation area of the participants, 36%-67% relied on the cream and performed neonatal circumcision. Conclusion: Pediatric surgeons consider that the idea of neonates to feel pain is important and despite its positive effect on pain, the cream is not used by all pediatric surgeons around the world. Despite its local anesthetic effect occurring without injection, side effects or usage difficulties, the cream will still be popular.

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“…Additionally, topical agents such as EMLA, a combination of 2.5% prilocaine and 2.5% lidocaine, has been shown to reduce pain associated with lumbar puncture at the time of needle insertion [ 143 ], although caution regarding the application is required especially in very preterm infants [ 140 ]. While topical anaesthetics have demonstrated some effectiveness for reducing circumcision-related pain [ 144 , 145 , 146 , 147 ], a recent review of 29 randomized trials demonstrated that topical anesthetics used as a single agent provided insufficient pain relief [ 148 ]. There is also strong evidence that topical anesthetics are ineffective in reducing the pain associated with heel lance [ 149 , 150 ], venipuncture [ 151 ], insertion of intravenous or intraarterial lines [ 152 , 153 ], and frenotomy [ 154 ].…”

Section: Management Of Neonatal Painmentioning

confidence: 99%

Assessment and Management of Pain in Preterm Infants: A Practice Update

2022

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Infants born preterm are at a high risk for repeated pain exposure in early life. Despite valid tools to assess pain in non-verbal infants and effective interventions to reduce pain associated with medical procedures required as part of their care, many infants receive little to no pain-relieving interventions. Moreover, parents remain significantly underutilized in provision of pain-relieving interventions, despite the known benefit of their involvement. This narrative review provides an overview of the consequences of early exposure to untreated pain in preterm infants, recommendations for a standardized approach to pain assessment in preterm infants, effectiveness of non-pharmacologic and pharmacologic pain-relieving interventions, and suggestions for greater active engagement of parents in the pain care for their preterm infant.

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Pain control in neonatal male circumcision: A best evidence review

Cited by 14 publications

References 45 publications

ShangRing versus Mogen clamp for early infant male circumcision in eastern sub-Saharan Africa: a multicentre, non-inferiority, adaptive, randomised controlled trial

ShangRing versus Mogen clamp for early infant male circumcision in eastern sub-Saharan Africa: a multicentre, non-inferiority, adaptive, randomised controlled trial

Dünya Çocuk Cerrahlarının Sünnette EMLA® Krem ile Oluşturulan Lokal Anestezi Hakkındaki Görüşleri Nedir?

Assessment and Management of Pain in Preterm Infants: A Practice Update

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