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To the Editor.—Dr Lander and colleagues¹ have shown once again the value and safety of anesthesia for neonatal circumcision. In this study, local infiltration ring block or dorsal penile nerve block resulted in less heart rate elevation and less crying during the circumcision procedure. Outcome measures said to have been investigated included heart rate, respiratory rate, oxygen saturation, palmar sweat, sleep-wake states, crying, motor responses, and methemoglobin level. Only heart rate, crying, and methemoglobin levels were reported, and the reader assumes that no significant changes were found in the remaining parameters.

A larger prospective, controlled, double-blinded study of the effectiveness of penile nerve block by Arnett et al² showed not only significantly less heart rate elevation and less crying in the anesthetized infant, but also demonstrated significant decrease in oxygen saturation when circumcision was done without anesthesia. Although Lander et al followed the technique of Kirya and Werthmann³ for . . . [Full Text of this Article]

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RELATED ARTICLE

Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision: A Randomized Controlled Trial
Janice Lander, Barbara Brady-Fryer, James B. Metcalfe, Shemin Nazarali, and Sarah Muttitt
JAMA. 1997;278(24):2157-2162.
ABSTRACT  

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