EMLA cream versus dorsal penile nerve block for postcircumcision analgesia in children

Anesth Analg. 2003 Feb;96(2):396-9, table of contents. doi: 10.1097/00000539-200302000-00018.

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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetaminophen / therapeutic use
  • Administration, Topical
  • Analgesics, Non-Narcotic / therapeutic use
  • Analgesics, Opioid / therapeutic use
  • Anesthetics, Combined / administration & dosage
  • Anesthetics, Combined / adverse effects
  • Anesthetics, Combined / therapeutic use*
  • Child
  • Child, Preschool
  • Circumcision, Male / adverse effects*
  • Double-Blind Method
  • Fentanyl / therapeutic use
  • Humans
  • Lidocaine / administration & dosage
  • Lidocaine / adverse effects
  • Lidocaine / therapeutic use*
  • Lidocaine, Prilocaine Drug Combination
  • Male
  • Nerve Block* / adverse effects
  • Pain Measurement / drug effects
  • Pain, Postoperative / drug therapy*
  • Penis / innervation*
  • Prilocaine / administration & dosage
  • Prilocaine / adverse effects
  • Prilocaine / therapeutic use*
  • Prospective Studies

Substances

  • Analgesics, Non-Narcotic
  • Analgesics, Opioid
  • Anesthetics, Combined
  • Lidocaine, Prilocaine Drug Combination
  • Prilocaine
  • Acetaminophen
  • Lidocaine
  • Fentanyl