Penile nerve block for newborn circumcision
Maxwell, L.G.; Yaster, M.; Wetzel, R.C.; Niebyl, J.R.
Obstetrics and Gynecology 70(3 Part 1): 415-419
1987
ISSN/ISBN: 0029-7844 PMID: 3627593 Document Number: 300105
Circumcision in neonates is performed, almost universally, without anesthesia or analgesia. It is associated with pain, crying, agitation, and physiologic stress. Twenty infants receiving penile nerve block for circumcision were compared with ten infants having circumcision without anesthesia. Heart rate and blood pressure rose 34 and 15%, respectively, in unblocked infants, and were unchanged in infants receiving local anesthesia. Oxygen saturation declined 16% in unanesthetized infants compared with 6% in blocked infants (P less than .03). Anesthetized infants were less agitated and cried less. Peak plasma concentrations of the local anesthetic lidocaine averaged 0.51 +/- 0.17 microgram/mL (range 0.1-1.6), well below accepted toxic levels. There were no local or systemic complications.