Pain management for newborn circumcision.
OBJECTIVE
To describe current newborn circumcision pain interventions and to identify which forms of analgesia were most effective.


METHODS
Each male newborn was assessed for pain during the circumcision procedure and at 15-minute intervals after the procedure using the FLACC pain scale. The type and combination of analgesia was also recorded on the pain assessment record.


RESULTS
Pain scores were highest for newborns receiving no analgesia during circumcision. Newborns circumcised with the dorsal block and the ring block in combination with the concentrated oral sucrose had the lowest pain scores. The sucrose alone did not provide sufficient analgesia; however, it did reduce the FLACC score somewhat when used in conjunction with other analgesics/anesthesia.


CONCLUSIONS
Information obtained from this project facilitated a change in policy wherein newborn circumcision is performed only with the use of analgesia and not concentrated oral sucrose alone.
Razmus
Ivy S
IS
Children's Hospital at Saint Francis, Tulsa, OK, USA.
Dalton
Madelyn E
ME
Wilson
David
D
D000284:Administration, Oral; D000698:Analgesia / Q000379:methods* / Q000451:nursing / Q000592:standards; D000704:Analysis of Variance; D019162:Anesthetics, Combined / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D002944:Circumcision, Male / Q000009:adverse effects* / Q000451:nursing; D015400:Clinical Nursing Research; D003131:Combined Modality Therapy; D006801:Humans; D007231:Infant, Newborn; D008012:Lidocaine / Q000627:therapeutic use; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009407:Nerve Block / Q000379:methods / Q000592:standards; D009730:Nursing Assessment; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods / Q000451:nursing / Q000592:standards; D011318:Prilocaine / Q000627:therapeutic use; D012720:Severity of Illness Index; D013391:Sucking Behavior; D013395:Sucrose / Q000008:administration & dosage; D017749:Total Quality Management / Q000458:organization & administration; D016896:Treatment Outcome
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D013395:Sucrose; D008012:Lidocaine