Local anesthesia for neonatal circumcision. Effects on distress and cortisol response

A controlled, double-blind investigation was conducted to determine whether the dorsal penile nerve block using lidocaine hydrochloride without epinephrine would effectively reduce behavioral distress and adrenocortical responses to routine neonatal circumcision. The subjects were healthy male newborns whose parents had requested circumcision. Equal numbers (n = 20) were randomly assigned to circumcision with lidocaine, saline, or no injection. Dorsal penile nerve block was found to be a safe and easy technique that was effective in reducing behavioral distress and modifying the adrenocortical stress response. The injection itself did not increase stress reactions and did not offset the beneficial effects of anesthesia. If circumcisions are to be performed, they should be done as humanely as possible.