A randomized, controlled trial of a eutectic mixture of local anesthetic cream (lidocaine and prilocaine) versus penile nerve block for pain relief during circumcision

OBJECTIVE: We set out to compare a eutectic mixture of local anesthetic cre am (lidocaine and prilocaine) to dorsal penile nerve block with lidocaine f or anesthesia during circumcision. STUDY DESIGN: In a double-blind study, term newborns were randomized to loc al anesthetic cream and sodium chloride solution dorsal penile nerve block (n = 31) or to placebo cream and lidocaine dorsal penile nerve block (n = 2 9). Pain was assessed by determination of heart rate, respiratory rate, and behavioral distress scoring. Group differences were evaluated with repeat- measures analyses of variance. RESULTS: Distress scores and heart rates were significantly higher in the e utectic mixture group than in the lidocaine group. Respiratory rates were h igher in the eutectic mixture group but did not reach statistical significa nce. CONCLUSIONS: Distress scores and heart rates were significantly higher in i nfants treated with the anesthetic mixture than in infants treated with lid ocaine. Dorsal penile nerve block with lidocaine is a more efficacious mean s of providing anesthesia for neonatal circumcision than the mixture of loc al anesthetics.