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Behavioral effects of circumcision with and without anesthesia.
Journal of Developmental and Behavioral Pediatrics : JDBP
|October 1, 1984
Summary
Neonatal circumcision can be painful, disrupting infant behavior. Local anesthesia, like a dorsal penile nerve block (DPNB), significantly improves behavioral recovery and infant comfort during and after the procedure.
Area of Science:
- Neonatal care
- Pediatric pain management
- Behavioral pediatrics
Background:
- Neonatal circumcision is a common procedure.
- Concerns exist regarding procedural pain and its impact on neonates.
- The Brazelton Neonatal Assessment Scale (BNAS) is a tool for evaluating infant behavior.
Purpose of the Study:
- To assess the behavioral effects of circumcision in neonates.
- To compare outcomes with and without local anesthesia (dorsal penile nerve block - DPNB).
- To evaluate the efficacy of DPNB in mitigating circumcision-related pain and stress.
Main Methods:
- Full-term neonates undergoing circumcision were studied.
- The Brazelton Neonatal Assessment Scale (BNAS) was used for blind evaluations.
- Assessments were conducted pre-procedure, post-procedure, and the following day.
Main Results:
- Infants receiving DPNB showed better attention to stimuli and self-quieting abilities.
- Motor behavior recovery was smoother and more mature in the anesthetized group.
- Behavioral differences persisted up to 24 hours post-procedure.
Conclusions:
- Circumcision is a painful event that can disrupt neonatal behavioral development.
- Local anesthesia (DPNB) effectively reduces pain and stress during circumcision.
- DPNB use is supported for routine neonatal circumcisions to improve infant outcomes.