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Pain relief in circumcision.(LETTERS)(Letter to the Editor)
I am not surprised by the findings of Praveen Kumar, M.D., of reluctance on the part of physicians to use adequate analgesia during circumcision ("No Analgesia Given in Most Circumcisions," Nov. 15, 2004, p. 4).
My experience at the community hospital level revealed that there is a belief among physicians that topical cream works as well as the dorsal penile nerve block or ring anesthesia. Physicians who lack training and experience in the administration of these options will become overnight converts once they witness their efficacy.
New physicians have to be proctored at our institution before getting approval for doing circumcision. To my dismay, as I proctored a new colleague, I noticed that nurses were applying a lidocaine cream topically, according to the physician's instructions.
I suggested that a dorsal penile nerve block might be more effective, and the procedure went smoothly. (I routinely use powdered sugar-coated pacifiers during the procedure.) Well, I have a convert! That physician has changed the practice from topical to penile block because an impressive analgesia was demonstrated.
Some time ago the Journal of the American Medical Association ...
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- Magazine article from: Pediatric Nursing Williamson, Marvel L. January 1, 1997 700+ words
...physiologic stress experienced by newborns undergoing unanesthetized circumcision from those who had received the dorsal penile nerve block (DPNB), a subcutaneous injection of 2-4 mg/kg (0.5 - 1.0 cc) of lidocaine (1% Xylocaine[R] without...
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- Pain relief in circumcision.(Letters)
- Magazine article from: Pediatric News Dave, Amar February 1, 2005 700+ words
...the part of physicians to use adequate analgesia during circumcision ("Raise...works as well as the dorsal penile nerve block or ring anesthesia. Physicians...the prepuce, we will at rain adequate analgesia. These agents could be used...
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- Magazine article from: Pediatric Nursing Olson, Traci L. July 1, 1998 700+ words
...To compare the efficacy of dorsal penile nerve block (DPNB) and eutectic mixture...of two anesthesia techniques (dorsal penile nerve block [DPNB] and eutectic mixture...familiarity with the analgesics and dorsal penile nerve block. Dorsal penile nerve block...
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- Newspaper article from: World Disease Weekly November 2, 2004 700+ words
...circumcision, according to Brady-Fryer's review, is the dorsal penile nerve block, using injections of the painkiller lidocaine. Compared...after injection or application to reach their full effect. Penile nerve blocks take five minutes, and the anesthetic creams take...
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...topical application of cream, emulsion or jel, or dorsal penile nerve block, and penile ring block are recommended for neonatal...20). In group 4 (local anaesthesia, n = 35), dorsal penile nerve block or penile ring block (1-2 or 2-4mL of lidocaine
- Circumcision pain relief is taught but underused.(Practice Trends)
- Magazine article from: Pediatric News Bell, John R. September 1, 2006 700+ words
...anesthesia to be either local methods (subcutaneous or dorsal penile nerve block) or topical anesthesia (a combination of lidocaine...commonly taught and most frequently used method was the dorsal penile nerve block; this method was taught in 81%, and used frequently...
- Study results from C. Giannantonio and colleagues in the area of pediatrics...
- Newspaper article from: Pediatrics Week July 25, 2009 700+ words
...examined the doses needed to provide adequate analgesia, extubation time after the discontinuation...of the use. Remifentanil provided adequate analgesia, with a significant reduction of...min, 97% of the newborns received adequate analgesia and sedation. The time elapsed between...
