RING BLOCK FOR NEONATAL CIRCUMCISION

Objective: To determine whether a difference in the behavioral and phy siologic response to circumcision can be demonstrated between neonates undergoing the procedure with ring block and those receiving no anest hesia. Methods: Forty healthy male newborns were assigned randomly to receive either ring block or no anesthesia. Indices of perceived pain including crying time, behavioral state, oxygen saturation, and heart and respiratory rates were recorded at baseline and at intervals durin g the circumcision. Infants were reassessed 2 minutes and 2 hours post operatively. Results: Infants receiving ring block cried less than did controls (P < .001). Anesthetized infants had smaller increases in he art rate (P < .005) and demonstrated less arousal (P < .005) during ea ch operative interval. For all operative intervals combined, anestheti zed infants had a smaller decrease in oxygen saturation (P < .001) and a smaller increase in respiratory rate (P = .005) than did controls. Two minutes postoperatively, anesthetized infants had returned to thei r baseline behavioral state, whereas controls remained significantly m ore aroused (P < .005). Two hours postoperatively, there were no signi ficant differences in any variables between the groups, nor between ea ch group and its baseline. There were no complications related to anes thesia administration. Conclusion: Neonatal circumcision causes behavi oral and physiologic changes consistent with the perception of pain. R ing block is an effective method of anesthesia for this procedure. (C) 1998 by The American College of Obstetricians and Gynecologists.