Comparing pain control using oral acetaminophen versus dorsal penile block in neonatal circumcision

Olakayode O Ogundoyin,Taiwo A Lawal,Dare I Olulana,Felix O Kumolalo

doi:10.1186/s43159-019-0002-z

Olakayode O Ogundoyin, Taiwo A Lawal + Show 2 more

Open Access

https://doi.org/10.1186/s43159-019-0002-z

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Abstract

BackgroundCircumcision is one of the commonest surgical procedures performed yet the most controversial worldwide. Although various reasons have been suggested in support of circumcision, the pain and stress that accompany it on both neonates and mothers are factors against the procedure. This study compared pain control using oral acetaminophen syrup versus 1% lidocaine injection given as dorsal penile block during neonatal circumcision.ResultsThere were 191 neonates in group A and 195 in group B. The mean age at circumcision was 23.71 (SD ± 20.39) days, and mean weight was 3.33 (SD ± 0.74) kg. The mean pain scores for group A immediately and 1 h after circumcision were 4.26 (SD ± 2.48) and 0.37 (SD ± 1.35), respectively. In group B, the mean pain scores immediately and 1 h after circumcision were 3.31 (SD ± 2.59) and 0.35 (SD ± 1.19), respectively.ConclusionPenile block gives better pain control in comparison with oral acetaminophen syrup, but both agents are effective and can be combined to provide a long-lasting perioperative anaesthesia and analgesia for circumcision in the hospital setting.

Highlights

Circumcision is one of the commonest surgical procedures performed yet the most controversial worldwide
Various agents have been used to provide anaesthesia for neonatal circumcision, and these include the use of local anaesthetic agents like lidnocaine injection without adrenaline, Eutectic Mixture of Local Anaesthetics (5% Eutectic Mixture of Local Anaesthesia (EMLA) cream) [15] and some other options like the use of oral acetaminophen syrup to provide analgesia, breast milk, oral sucrose solution and honey as pacifiers
Following an ethical approval, informed consent was obtained from the parents of the neonates who were allocated into two groups as follows: group A and group B

Summary

Introduction

Circumcision is one of the commonest surgical procedures performed yet the most controversial worldwide. This study compared pain control using oral acetaminophen syrup versus 1% lidocaine injection given as dorsal penile block during neonatal circumcision. Circumcision in males is the surgical removal of the prepuce from the penis. It is one of the most common surgical procedures performed yet the most controversial in the world [1,2,3]. Neonatal male circumcision is performed for various reasons, which range from medical, religious, cultural to social reasons. We aimed at comparing the efficacy of oral acetaminophen syrup with that of 1% lidocaine (without adrenaline) injection given as dorsal penile block during neonatal circumcision

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Conclusion