Bupivacaine versus lidocaine analgesia for neonatal circumcision

被引:9
作者
Stolik-Dollberg O.C. [1 ,3 ]
Dollberg S. [2 ,3 ]
机构
[1] Department of Anesthesiology, Sheba Medical Center, Tel Hashomer
[2] Department of Neonatology, Tel Aviv Sourasky Medical Center, Tel Aviv 64239
[3] Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv
关键词
Dorsal penile nerve block; EMLA cream; Long-term effects; Post-operative pain;
D O I
10.1186/1471-2431-5-12
中图分类号
学科分类号
摘要
Background: Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB) when performing neonatal circumcision. Methods: Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivacaine. The outcome variable was the administration by the parents of acetaminophen during the ensuing 24 hours. Results: Seventeen infants received lidocaine and 19 received bupivacaine DPNB. Ten infants in the lidocaine group (59%) were given acetaminophen following circumcision compared to only 3 (16%) in the bupivacaine group (P<0.01). Regression analysis showed that the only significant variable associated with the need for acetaminophen was the use of lidocaine (R2=20.6; P=0.006). Conclusion: DPNB with bupivacaine for neonatal circumcision apparently confers better analgesia than lidocaine as judged by the requirement of acetaminophen over the ensuing 24-hour period. © 2005 Stolik-Dollberg and Dollberg, licensee BioMed Central Ltd.
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页数:4
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  • [1] Ryan C.A., Finer N.N., Changing attitudes and practices regarding local analgesia for newborn circumcision, Pediatrics, 94, pp. 230-233, (1994)
  • [2] Taddio A., Goldbach M., Ipp M., Stevens B., Koren G., Effect of neonatal circumcision on pain responses during vaccination in boys, Lancet, 345, pp. 291-292, (1995)
  • [3] Taddio A., Katz J., Ilersich A.L., Koren G., Effect of neonatal circumcision on pain response during subsequent routine vaccination, Lancet, 349, pp. 599-603, (1997)
  • [4] Lannon C.M., Doll-Bailey A.G., Fleishman A.R., Kaplan G.W., Shoemaker C.T., Swanson J.T., Coustan D., Circumcision policy statement (No. RE9850), (1999)
  • [5] Taddio A., Ohlsson A., Lidocaine-prilocaine cream (EMLA) to reduce pain in male neonates undergoing circumcision, Cochrane Database Syst. Rev., 2, (2000)
  • [6] Choi W.Y., Irwin M.G., Hui T.W., Lim H.H., Chan K.L., EMLA cream versus dorsal penile nerve block for post circumcision analgesia in children, Anesth. Analg., 96, pp. 396-399, (2003)
  • [7] Dix P., Martindale S., Stoddart P.A., Double-blind randomized placebo-controlled trial of the effect of ketamine on postoperative morphine consumption in children following appendicectomy, Paediatr. Anaesth., 13, pp. 422-426, (2003)
  • [8] Gauntlett I., A comparison between local anaesthetic dorsal nerve block and caudal bupivacaine with ketamine for paediatric circumcision, Paediatr. Anaesth., 13, pp. 38-42, (2003)
  • [9] Bolton P., Bridge H.S., Montgomery C.J., Merrick P.M., The analgesic efficacy of preoperative high dose (40 mg × kg(-1)) oral acetaminophen after bilateral myringotomy and tube insertion in children, Paediatr. Anaesth., 12, pp. 29-35, (2002)
  • [10] Treluyer J.M., Tonnelier S., d'Athis P., Leclerc B., Jolivet-Landreau I., Pons G., Antipyretic efficacy of an initial 30 mg-mg/kg dose of acetaminophen versus a 15-mg/kg dose, Pediatrics, 108, (2001)