title: EMLA cream versus dorsal penile nerve block for postcircumcision analgesia in children.
abstract: We conducted a prospective, randomized, double-blinded trial comparing preoperative application of EMLA cream and sodium chloride solution dorsal penile block (n = 31) with placebo cream and bupivacaine dorsal penile nerve block (n = 32) for postcircumcision analgesia. Pain was assessed using modified Children's Hospital of Eastern Ontario Pain Scale and the duration of block by the time to requirement of first dose of postoperative analgesic. There was no difference in Children's Hospital of Eastern Ontario Pain Scale between the two groups, but bupivacaine dorsal penile nerve block resulted in longer analgesia (P = 0.003). There were no local or systemic complications related to either technique, and there was a very small incidence of vomiting. We conclude that preoperative application of EMLA cream is an effective and simple method to produce postcircumcision analgesia with a very small incidence of adverse effects.
authors.affiliation: Department of Anaesthesia and Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong. reginachoi@hotmail.com
authors.forename: W Y
authors.initials: WY
authors.lastname: Choi
authors.forename: M G
authors.initials: MG
authors.lastname: Irwin
authors.forename: T W C
authors.initials: TW
authors.lastname: Hui
authors.forename: H H
authors.initials: HH
authors.lastname: Lim
authors.forename: K L
authors.initials: KL
authors.lastname: Chan
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000287:Administration, Topical; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D019162:Anesthetics, Combined / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male / Q000009:adverse effects*; D004311:Double-Blind Method; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009407:Nerve Block / Q000009:adverse effects; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D010413:Penis / Q000294:innervation*; D011318:Prilocaine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D000082:Acetaminophen; D008012:Lidocaine; D005283:Fentanyl