Infant physiological responses to noxious stimuli of circumcision with anesthesia and analgesia.

PURPOSE: To compare the efficacy of dorsal penile nerve block (DPNB) and eutectic mixture of local anesthetic (EMLA) for attenuation of neonatal pain during circumcision.

METHOD: A total of 20 infants born at a United States upper Midwestern hospital were involved in the study. Measurements of blood pressure, heart rate, respiratory rate, and oxygen saturation were obtained along with a Neonatal Infant Pain Scale (NIPS) grading at five separate intervals (baseline, restraint, incision, Gomco clamp application, and post circumcision) throughout the circumcision procedure. A comparison was done between the two groups regarding response to the noxious stimuli.

FINDINGS: Infants demonstrate physiological and behavioral response to pain. These physiological and behavioral responses are observable and measurable. In addition, results show less response with the DPNB as compared to the EMLA.

CONCLUSIONS: There is a trend toward better pain control with the DPNB as compared to EMLA.