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Related Experiment Videos

Neonatal cortisol response to circumcision with anesthesia.

P S Williamson, N D Evans

    Clinical Pediatrics
    |August 1, 1986
    PubMed
    Summary

    Local anesthesia did not significantly reduce the adrenal cortisol response in newborns undergoing circumcision. Pain signals may still reach the brain, causing a stress response despite nerve blocks.

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    Area of Science:

    • Pediatric Surgery
    • Anesthesiology
    • Endocrinology

    Background:

    • Newborn circumcision is a common procedure.
    • Pain management during infant circumcision is crucial.
    • The effectiveness of local anesthesia in mitigating surgical stress response needs evaluation.

    Purpose of the Study:

    • To assess the impact of a dorsal penile nerve block on the adrenal cortisol response during infant circumcision.
    • To compare cortisol levels in newborns circumcised with and without local anesthesia.

    Main Methods:

    • Eleven male newborns received a dorsal penile nerve block before circumcision.
    • Thirteen control infants underwent circumcision without anesthesia.
    • Pre- and post-procedure cortisol levels were measured and compared between groups.

    Main Results:

    • The administration of lidocaine via dorsal penile nerve block did not significantly reduce the adrenal cortisol response to circumcision.
    • Blood sampling and venipuncture alone did not trigger an adrenal response in uncircumcised infants.
    • Cortisol elevation persisted despite regional nerve pathway blockage.

    Conclusions:

    • Regional anesthesia may not fully block the neuroendocrine stress response to circumcision in newborns.
    • Cortical input or secondary epinephrine release could contribute to cortisol elevation.
    • Further research is needed to optimize pain management and reduce surgical stress in infant circumcision.

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