title: Comparison of local anesthetic effects of lidocaine versus tramadol and effect of child anxiety on pain level in circumcision procedure.
abstract: OBJECTIVE
  To compare the local anesthetic effects of tramadol hydrochloride with those of lidocaine in circumcision procedures. We also investigated the effect of child anxiety on pain level.
  
  
  METHODS
  A total of 70 children were included in this study. The children were randomized into 3 groups. Group 1 (n = 26) received lidocaine hydrochloride + epinephrine and they underwent circumcision using Ali's clamp(®). Group 2 (n = 35) received lidocaine hydrochloride + epinephrine and group 3 (n = 12) 5% tramadol. The last two groups underwent conventional circumcision.
  
  
  RESULTS
  The mean anxiety score was 22.6. We did not find significant differences in terms of anxiety score among the groups (p = 0.761). When the pain scores of the groups during injection were compared, it was found that there were no significant differences. However, the pain score of the third group was significantly high when it was compared with the first and second group 2 and 10 min after injection. In the correlation analysis, we found a positive correlation between children's anxiety scores and the pain degree during injection (r = 0.373, p = 0.001).
  
  
  CONCLUSIONS
  Tramadol may not provide effective local anesthesia in male circumcision. The child's anxiety before the circumcision seems to have a negative effect on pain level.
authors.affiliation: Gazi University School of Medicine, Department of Urology, Ankara, Turkey.
authors.forename: Fazli
authors.initials: F
authors.lastname: Polat
authors.forename: Altug
authors.initials: A
authors.lastname: Tuncel
authors.forename: Melih
authors.initials: M
authors.lastname: Balci
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Aslan
authors.forename: Ozlem
authors.initials: O
authors.lastname: Sacan
authors.forename: Cebrail
authors.initials: C
authors.lastname: Kisa
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kayali
authors.forename: Ali
authors.initials: A
authors.lastname: Atan
mesh_terms: D000779:Anesthetics, Local / Q000627:therapeutic use*; D001007:Anxiety; D002648:Child; D002944:Circumcision, Male; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control* / Q000523:psychology*; D010290:Parents / Q000523:psychology; D014147:Tramadol / Q000627:therapeutic use*
chemical_list: D000779:Anesthetics, Local; D014147:Tramadol; D008012:Lidocaine