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Attitudes and practices regarding analgesia for newborn circumcision
1Department of Paediatrics, Children's Hospital of Western Ontario, London, Canada.
Pediatrics
|October 1, 1993
Summary
Most physicians performing newborn circumcisions do not use analgesia, often due to unfamiliarity with techniques or concerns about adverse effects. Educational initiatives are needed to improve pain management during infant circumcision.
Area of Science:
- Pediatric Medicine
- Pain Management
- Neonatal Care
Background:
- Newborn circumcision is a common procedure.
- Evidence suggests neonates experience pain and stress during circumcision.
- Analgesia can reduce the physiological stress response to circumcision.
Purpose of the Study:
- To assess primary care physician attitudes towards routine analgesia for newborn circumcision.
- To identify barriers to analgesic use in neonatal circumcision.
Main Methods:
- A questionnaire survey was distributed to family physicians and pediatricians in southwestern Ontario.
- 171 physicians (61% response rate) completed the survey.
- The survey focused on current practices and beliefs regarding analgesia for infant circumcision.
Main Results:
- 43% of respondents performed circumcisions, but only 24% used any analgesia.
- Oral ethanol was the most common analgesic; dorsal penile nerve block was rarely used (4%).
- Key barriers included lack of familiarity with neonatal analgesia (56%) and dorsal penile block (50%), and concerns about adverse effects (49%).
Conclusions:
- A significant gap exists between evidence-based pain management and current practice for newborn circumcision.
- Lack of physician familiarity with analgesia techniques is a major obstacle.
- Urgent need for educational interventions and research into effective, less invasive analgesia methods for infant circumcision.