Impact of the Universal Adoption of Ring Block Anesthesia Pre-Circumcision in a Tertiary Care Center [26I

Abstract

INTRODUCTION: Neonatal circumcision causes behavioral and physiologic changes consistent with the perception of pain. Ring block anesthesia pre-circumcision leads to a smaller increase in heart rate and respiratory rate. They demonstrated less arousal during each operative interval, less crying and a smaller decrease in oxygen saturation compared to infants not receiving anesthesia. A Joint commission site visit to our institution in March 2014 prompted the adoption of pre-circumcision anesthesia preferably ring block in April 2014 with the mindset of providing our pediatric patients with the same high quality care during a painful procedure. METHODS: A descriptive analysis of circumcision related data pertaining to the use of ring block anesthesia during circumcisions performed at Erlanger tertiary care facilities from March 2013 through March 2015. RESULTS: The use of ring block anesthesia application increased to 94.1% (n= 1394) out of 1482 post adoption compared to the prior 41.1% (n=727) out of 1770). Of note is the reduction in the total number of circumcision done in the hospital from n=1770 between March 2013 and 2014 to n=1394 between April 2014 and March 2015 of the study period. CONCLUSION: The near perfect implementation of ring block anesthesia pre-neonatal circumcision does illustrate the importance of hospital encouraged compliance in improving the quality of medical practice.