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EMLA cream versus dorsal penile nerve block for postcircumcision analgesia in children

W Y Choi1, M G Irwin, T W C Hui

  • 1Department of Anaesthesia and Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong. reginachoi@hotmail.com

Anesthesia and Analgesia
|January 23, 2003
PubMed

Insights

EMLA cream provides effective post-circumcision pain relief with minimal side effects. While it didn't reduce pain scores, it offered a simple method for analgesia.

Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Pain Management

Background:

  • Post-circumcision pain management is crucial for infant well-being.
  • Effective and safe analgesia methods are continuously sought.

Purpose of the Study:

  • To compare the efficacy of EMLA cream with a dorsal penile nerve block for post-circumcision analgesia.
  • To evaluate pain scores and duration of analgesia.

Main Methods:

  • Prospective, randomized, double-blinded trial.
  • EMLA cream and sodium chloride solution dorsal penile block vs. placebo cream and bupivacaine dorsal penile nerve block.
  • Pain assessment using modified Children's Hospital of Eastern Ontario Pain Scale; duration of block assessed by time to first postoperative analgesic.

Main Results:

  • No significant difference in pain scores between groups.
  • Bupivacaine dorsal penile nerve block provided significantly longer analgesia (P = 0.003).
  • Low incidence of adverse effects, including minimal vomiting, in both groups.

Conclusions:

  • Preoperative EMLA cream application is an effective and simple method for post-circumcision analgesia.
  • EMLA cream is associated with a very low incidence of adverse effects.
  • Dorsal penile nerve block with bupivacaine offers prolonged analgesia but EMLA cream provides a simpler alternative.

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