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Related Experiment Videos

Pain management for neonatal circumcision.

A Taddio1

  • 1Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada.

Paediatric Drugs
|March 28, 2001
PubMed
Summary

Pain management during infant circumcision is crucial. Combining dorsal penile nerve block (DPNB) with sucrose and using the Mogen clamp offers the most effective pain relief and stress reduction.

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Area of Science:

  • Neonatal care
  • Pain management
  • Pediatric surgery

Background:

  • Circumcision is a common neonatal procedure in North America.
  • Untreated pain can lead to short and long-term behavioral changes in infants.
  • Effective pain management strategies are essential for infant well-being.

Purpose of the Study:

  • To review pharmacological and non-pharmacological interventions for pain relief during infant circumcision.
  • To evaluate the efficacy of different pain management modalities and combinations.
  • To recommend optimal pain control strategies for neonatal circumcision.

Main Methods:

  • Review of randomized controlled trials and meta-analyses on circumcision pain management.
  • Comparison of pharmacological methods including dorsal penile nerve block (DPNB), topical anesthetics (EMLA), and oral sucrose.
  • Evaluation of non-pharmacological interventions like pacifiers and restraint devices.
  • Assessment of surgical instruments (Mogen clamp vs. Gomco clamp) regarding pain and procedure time.

Main Results:

  • Dorsal penile nerve block (DPNB) with lidocaine is effective, with a low risk of injection-related adverse effects (6.7%).
  • Topical anesthetics and oral sucrose are less effective than DPNB.
  • Combined analgesia (e.g., DPNB + sucrose pacifier) shows significant benefits over single interventions.
  • The Mogen clamp is associated with shorter procedure times and less pain compared to the Gomco clamp.

Conclusions:

  • A multimodal approach combining pharmacotherapy and non-pharmacological methods is recommended for optimal pain management.
  • Recommended interventions include DPNB, oral sucrose, pacifiers, and comfortable restraint.
  • Utilizing the Mogen clamp technique alongside combined analgesia is advised for infant circumcision.

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