title: A randomized, controlled trial of a eutectic mixture of local anesthetic cream (lidocaine and prilocaine) versus penile nerve block for pain relief during circumcision.
abstract: OBJECTIVE
  We set out to compare a eutectic mixture of local anesthetic cream (lidocaine and prilocaine) to dorsal penile nerve block with lidocaine for anesthesia during circumcision.
  
  
  METHODS
  In a double-blind study, term newborns were randomized to local anesthetic cream and sodium chloride solution dorsal penile nerve block (n = 31) or to placebo cream and lidocaine dorsal penile nerve block (n = 29). Pain was assessed by determination of heart rate, respiratory rate, and behavioral distress scoring. Group differences were evaluated with repeat-measures analyses of variance.
  
  
  RESULTS
  Distress scores and heart rates were significantly higher in the eutectic mixture group than in the lidocaine group. Respiratory rates were higher in the eutectic mixture group but did not reach statistical significance.
  
  
  CONCLUSIONS
  Distress scores and heart rates were significantly higher in infants treated with the anesthetic mixture than in infants treated with lidocaine. Dorsal penile nerve block with lidocaine is a more efficacious means of providing anesthesia for neonatal circumcision than the mixture of local anesthetics.
authors.affiliation: Department of Pediatrics, Rochester General Hospital, The University of Rochester School of Medicine and Dentistry, NY 14621, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Howard
authors.forename: F M
authors.initials: FM
authors.lastname: Howard
authors.forename: K
authors.initials: K
authors.lastname: Fortune
authors.forename: P
authors.initials: P
authors.lastname: Generelli
authors.forename: D
authors.initials: D
authors.lastname: Zolnoun
authors.forename: C
authors.initials: C
authors.lastname: tenHoopen
authors.forename: E
authors.initials: E
authors.lastname: deBlieck
mesh_terms: D000279:Administration, Cutaneous; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002944:Circumcision, Male; D004311:Double-Blind Method; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007279:Injections, Subcutaneous; D008012:Lidocaine / Q000008:administration & dosage; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009407:Nerve Block; D010146:Pain / Q000517:prevention & control; D011318:Prilocaine / Q000008:administration & dosage
chemical_list: D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine