Journal of Rafsanjan University of Medical Sciences

  Comparing the Effect of 10% Lidocain Spray and Dorsal Penis Nerve Block on the Pain of Neonatal Circumcision

  M. Abedinzadeh MD [1] , M. Kazemi MSc [2] , G. Kholasezadeh MD [3] , V. Mashayekhi GP [4] , R. Vazirinejad PhD [5]

  Recived: 25/09/2005 Revised: 5/07/2006 Accepted: 15/07/2006

  Background and Objective: Neonates have complete insight into the pain. Pain not only causes physiologic and emotional alteration in neonates but also has long-term detrimental effects. Circumcision using dorsal penis nerve block is one of the most common surgical procedures in male neonates. Despite this method is effective, it has few complications. For instance, there is the risk of injecting lidocain in the vein and also there is the possibility of formation of hematoma on the injection site. However, lidocain spray does not cause these complications. The present study is conducted to compare the effect of these two methods on the level of pain after circumcision.

  Materials and Methods: This randomized clinical trail study was conducted on 54 neonates who were circumcised. Of these, 25 neonates were anaesthetized using lidocain spray 10%. The remaining (n=29) were received dorsal penis nerve block for the local anesthesia. The severity of pain was measured using Neonatal Infant Pain Scale (NIPS) in three different occasions when the circumcision procedure was being condacted (time 0), and 15 and 30 minutes after circumcision. Mann Whitney U test and t-test were used for comparing the severity of pain in the two groups.

  Results: In both groups severity of pain was decreasing over the time. The severity of pain among those who received dorsal penis nerve block was less than that of neonates in the other group in both occasions during circumcision (time 0) and 15 minutes after circumcision. However, there was no significant difference of pain severity between the two groups 30 minutes after circumcision.

  Conclusion: During circumaision and 15 minutes after the procedure, the effect of lidocain spray on the pain of circumcision was less than the effect of dorsal penis nerve block. However, 30 minutes after circumcision the effect of lidocain spray on the pain was comparable with the effect of dorsal penis nerve block method. It can be concluded that regarding the physiological and emotional responses after circumcision, in comparison with lidocain spray, dorsal penis nerve block can be a more effective method for relieving the pain caused by circumcision. However, more investigations are needed to study the side effects of this method.

 �

  Key words: Circumcision, Lidocain Spray, Dorsal Penis Nerve Block, Neonate

  [1] - Assistant Dept. of Urology, University of Medical Sciences, Rafsanjan

  (Corresponding Author) Tel: (021) 22588016, Fax: (021) 22588016, Email: abedin100@yahoo.com

  [2] - Academic Member, Dept. of Nursing, University of Medical Sciences, Rafsanjan

  [3] - Assistant Dept. of Psychiatry, University of Medical Sciences, Rafsanjan

  [4] -General Physician, University of Medical Sciences, Rafsanjan

  [5] - Assistant Dept. of Epidemiology, University of Medical Sciences, Rafsanjan