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Changing attitudes and practices regarding local analgesia for newborn circumcision
1Department of Newborn Medicine, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Pediatrics
|August 1, 1994
Summary
A simple educational program significantly increased the use of local anesthesia for newborn circumcision. This initiative aimed to improve pain management during the procedure, with a goal of universal adoption of regional anesthesia.
Area of Science:
- Medical Education
- Pediatric Surgery
- Pain Management
Background:
- Neonatal circumcision is a common procedure with varying pain management practices.
- Routine use of local and regional anesthesia for newborn circumcision is not consistently applied.
- Physician attitudes and practices require intervention to improve analgesia during neonatal circumcision.
Purpose of the Study:
- To evaluate the impact of an educational intervention on physician practices regarding anesthesia for newborn circumcision.
- To increase the routine use of local and regional anesthesia in neonatal circumcision procedures.
Main Methods:
- An interventional study involving a comprehensive educational program for physicians performing newborn circumcisions.
- The intervention included posters, newsletters, grand rounds presentations, videos, and hands-on demonstrations of anesthesia techniques.
- Physician practice was audited 1 year following the educational interventions.
Main Results:
- Prior to the intervention, only one physician routinely used local analgesia for newborn circumcision.
- Following the educational program, 66% (32/48) of circumcisions utilized local analgesia (prepuce or dorsal penile nerve block).
- Six physicians (performing 16 circumcisions) did not use any form of analgesia.
Conclusions:
- A straightforward educational initiative led to a significant shift in physician attitudes and practices concerning local analgesia for neonatal circumcision.
- The study highlights the effectiveness of targeted education in improving pain management during newborn circumcision.
- The ultimate goal is to ensure all newborn circumcisions are performed with local or regional anesthesia through ongoing education and practical training.