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An evidence-based multidisciplinary protocol for neonatal circumcision pain management
Janet Geyer1, Dan Ellsbury, Charmaine Kleiber
1Children's Hospital of Iowa, University of Iowa Hospitals and Clinics, Iowa City 52242-1009, USA. janet-geyer@uiowa.edu
Insights
Infant pain from circumcision can have long-term effects. This study evaluates interventions like sucrose pacifiers and acetaminophen to minimize pain during neonatal circumcision.
Area of Science:
- Neonatal care
- Pain management
- Pediatric surgery
Background:
- Neonatal circumcision is a common procedure associated with pain and distress.
- Infant pain experiences may lead to long-term neurodevelopmental consequences.
- Effective pain management is crucial for infant well-being.
Purpose of the Study:
- To review and evaluate evidence for interventions to minimize pain during neonatal circumcision.
- To discuss the implementation of a comprehensive pain control standard of practice.
Main Methods:
- Literature review of interventions including sucrose pacifiers, buffered lidocaine, acetaminophen, swaddling, and environmental modifications.
- Evaluation of the evidence supporting each pain management technique.
- Discussion on establishing a standard of care for neonatal circumcision pain control.
Main Results:
- Dorsal penile nerve block is a primary intervention.
- Sucrose pacifiers, buffered lidocaine, small needles, acetaminophen, swaddling, and environmental modifications show varying degrees of evidence for pain reduction.
- A comprehensive, evidence-based approach is recommended.
Conclusions:
- Multiple interventions can effectively reduce pain and distress during neonatal circumcision.
- Implementing a standardized, evidence-based pain management protocol is essential.
- Minimizing neonatal procedural pain is critical for infant health outcomes.
Abstract:
Pain experienced in infancy may have effects later in life. Neonatal circumcision is a common painful procedure. In addition to dorsal penile nerve block, interventions that may have a role in minimizing pain and distress in neonatal circumcision include use of a sucrose pacifier, buffered lidocaine, small needles, acetaminophen, swaddling, and environmental modification. The evidence for each intervention is presented and evaluated. Implementation of a comprehensive evidence-based circumcision pain control standard of practice is discussed.