Combined Analgesia and Local Anesthesia to Minimize Pain During Circumcision

Taddio, Anna; Pollock, Neil; Gilbert-MacLeod, Cheryl A.; Ohlsson, Kristina; Koren, Gideon

doi:10.1001/archpedi.154.6.620

Cited by 56 publications

(33 citation statements)

References 24 publications

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“…According to Taddio et al (2000) both acetaminophen and ketorolac are safe drugs regarding cardiac activity, respiratory function and temperature regulation. So findings in this study are consistent with their inference 26 . The safety status of intravenous ketorolac in neonates was ascertained principally on two variables: bleeding tendency and serum creatinine levels during postoperative period.…”

Section: Discussionsupporting

confidence: 92%

“…Efficacy was assessed principally by use of pain scoring (CRIES) and was found to be significantly low with ketorolac during all four postoperative days indicating better analgesic efficacy. According to Taddio et al (2000) regarding pain relief during operation, found Facial action scores and percentage of time spent crying were significantly lower during circumcision for infants in group who took ketorolac (P<.001) 26 . The percentage of time spent crying was 18% and 40% for infants in groups 1 and 2, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Use of Intravenous Ketorolac as Postoperative Analgesic in Neonates: A Prospective Study in Chittagong, Bangladesh

Parveen

Jahangir

Haque

et al. 2015

Chatt Maa Shi Hosp Med Coll J

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Use of Intravenous Ketorolac as Postoperative Analgesic in Neonates: A Prospective Study in Chittagong, Bangladesh

Parveen

Jahangir

Haque

et al. 2015

Chatt Maa Shi Hosp Med Coll J

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“…[7][8][9][10] The combination of topical lidocaine-prilocaine with dorsal penile nerve block has been shown to be safe with less pain than topical lidocaine-prilocaine alone. 14 The utilization of topical lidocaine-prilocaine cream at the base of the penis prior to injection to reduce injection site pain during dorsal penile nerve blockade seems sensible, but has only been studied in older children undergoing circumcision. 19 Pain scores were similar when comparing reviewers with a medical background and those having no medical background.…”

Section: Discussionmentioning

confidence: 99%

“…These behavioral components have been videotaped for the investigators to complete analysis. [7][8][9][10][11][12][13][14] Video studies have only been reviewed by the study investigators and never reviewed by noninvestigators or by nonmedical persons. In addition, no studies have used sham procedures in comparing anesthesia techniques or evaluate baseline levels of pain.…”

Section: Introductionmentioning

confidence: 99%

A video study of pain relief during newborn male circumcision

et al. 2005

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Objective: The purpose of this investigation was to compare the effectiveness of dorsal penile nerve block and topical lidocaine-prilocaine anesthesia techniques for pain relief during circumcision.Methods: In total, 18 healthy term newborn males were divided based on anesthesia. The topical lidocaine-prilocaine group had six males undergoing circumcision and three males undergoing a sham procedure. The dorsal penile nerve block group had six males undergoing circumcision and three males undergoing a sham procedure. The procedures were videotaped and viewed by 90 noninvestigator reviewers who scored the infants' pain using the Neonatal Infant Pain Scale and a numeric pain scale. Statistical analysis utilized a P-value of <0.05 as significant.Results: The median Neonatal Infant Pain Scale and numeric pain scores were significantly lower in the dorsal penile nerve block group than in the topical lidocaine-prilocaine group or the sham group (Neonatal Infant Pain Scale: 1.0 (range 0-6) versus 6.0 (range 2-6) versus 4.0 (range 0-6), P<0.001, respectively; numeric pain scale: 2.0 (range 0-10) versus 8.0 (range 1-10) versus 4.0 (range 0-10), P<0.001, respectively). In the sham group, procedures with the dorsal penile nerve block had significantly lower pain scores than those with topical lidocaine-prilocaine (Neonatal Infant Pain Scale: 1.0 (range 0-6) versus 5.0 (range 2-6), P<0.001; numeric pain scale: 1.0 (0-8) versus 6.0 (range 0-10), P<0.001). When reviewers were divided by medical background, gender or parental status, no differences in pain scores were observed. Conclusion:The dorsal penile nerve block anesthesia technique for newborn male circumcision was significantly more effective for pain relief than topical lidocaine-prilocaine.

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“…Finally, it is important to consider the combination of various treatment modalities to maximize their analgesic effects and minimize the adverse effects or toxicity. 81 Perioperative Pain Nearly 1.4 million infants in the United States undergo operative procedures each year. 49 Pain management for these infants must include intraoperative and postoperative interventions.…”

Section: Procedural Painmentioning

confidence: 99%

Summary Proceedings From the Neonatal Pain-Control Group

et al. 2006

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Recent advances in neurobiology and clinical medicine have established that the fetus and newborn may experience acute, established, and chronic pain. They respond to such noxious stimuli by a series of complex biochemical, physiologic, and behavioral alterations. Studies have concluded that controlling pain experience is beneficial with respect to short-term and perhaps long-term outcomes. Yet, pain-control measures are adopted infrequently because of unresolved scientific issues and lack of appreciation for the need for control of pain and its long-term sequelae during the critical phases of neurologic maturation in the preterm and term newborn. The neonatal pain-control group, as part of the Newborn Drug Development Initiative (NDDI) Workshop I, addressed these concerns. The specific issues addressed were (1) management of pain associated with invasive procedures, (2) provision of sedation and analgesia during mechanical ventilation, and (3) mitigation of pain and stress responses during and after surgery in the newborn infant. The cross-cutting themes addressed within each category included (1) clinical-trial designs, (2) drug prioritization, (3) ethical constraints, (4) gaps in our knowledge, and (5) future research needs. This article provides a summary of the discussions and deliberations. Full-length articles on procedural pain, sedation and analgesia for ventilated infants, perioperative pain, and study designs for neonatal pain research were published in Clinical Therapeutics (June 2005).www.pediatrics.org/cgi

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Combined Analgesia and Local Anesthesia to Minimize Pain During Circumcision

Cited by 56 publications

References 24 publications

Use of Intravenous Ketorolac as Postoperative Analgesic in Neonates: A Prospective Study in Chittagong, Bangladesh

Use of Intravenous Ketorolac as Postoperative Analgesic in Neonates: A Prospective Study in Chittagong, Bangladesh

A video study of pain relief during newborn male circumcision

Summary Proceedings From the Neonatal Pain-Control Group

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