- Serour F, Mandelberg A, Zabeeda D, et al [Edith Wolfson Med Ctr, Holon, Israel]
Efficacy of EMLA Cream Prior to Dorsal Penile Nerve Block for Circumcision in Children
Acta Anaesthesiol Scand 42: 260-263, 1998
A prosective, double-blind, placebo-controlled randomized study involving the use of a local anesthetic cream [EMLA] to the pubic area of 6 boys prior to dorsal penile nerve block is reported. 21 of the 42 boys between the ages of 7 and 17 years applied the cream and the remaining 21 the placebo. The time period of application between the two groups was the same.
Those applying the active agent reported an absence of the prick sensation but 3 felt the sensation of pain at infiltration of the anesthetic. In the control group, varying degree of pain was felt by all the participants.
This EMLA cream is useful in reducing needle prick induced pain.
- Lander J, Brady-Fryer B, Metcalfe JB, et al [Univ of Alberta, Edmonton, Canada]
Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision: A Randomized Controlled Trial
JAMA 278: 2157-2162, 1997
This work compares the effects ring block, mixture of local anesthetics [EMLA], dorsal penile nerve block and topical placebo in neonatal circumcision. 52 normal full-term healthy 1-3 days old boys were studied. Basis of evaluation comprised, heart rate, cry and methemoglobin level.
In the control group, sustained increase in heart-rate as well as cry during and after surgery were observed constantly. Two developed choking and apnea. EMLA causes asymptomatic methemoglobinemia.
All 3 modalities reduced the cry and heart rate rise. Penile nerve block and EMLA did not reduce discomfort experienced during separation of the foreskin and incision. Total absence of discomfort was observed with ring block, hence it is the anesthetic agent of choice.