Abstract:
OBJECTIVE:Circumcision is a common neonatal surgical procedure routinely performed without the use of anesthesia. The purpose of this study was to evaluate the safety and efficacy of topical lidocaine cream as an anesthetic for circumcision. METHODS:Thirty newborns were studied in a randomized, double-blind, placebo-controlled study; 15 received a topical 30% lidocaine cream and 15 received the cream base alone. Vital signs were recorded, and preoperative and postoperative serum beta-endorphin and lidocaine concentrations were measured. A videotape of the newborn was used to score behavioral changes. RESULTS:Comparisons of the vital signs precircumcision and postcircumcision showed no differences between the placebo and treatment groups, with the exception of mean systolic blood pressure, which significantly increased in the placebo-treated newborns (P < .05). Serum beta-endorphin concentrations increased postoperatively in 11 of 15 subjects receiving placebo, but decreased or remained unchanged in 10 of 15 subjects receiving lidocaine (P = .03, Fisher's exact test). When stress-related behaviors in the precircumcision and post-circumcision periods were compared, the mean increase in their occurrence was greater in the placebo than in the treatment group. There was no significant absorption of lidocaine as measured in the serum. CONCLUSION:Topical application of a 30% lidocaine cream as used in this study may be a safe and efficacious anesthetic for circumcision.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Weatherstone KB,Rasmussen LB,Erenberg A,Jackson EM,Claflin KS,Leff RDsubject
Has Abstractpub_date
1993-11-01 00:00:00pages
710-4issue
5eissn
0031-4005issn
1098-4275journal_volume
92pub_type
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