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GEN: Sucrose pacifier and Circ PainFrom: Geffrey H. Klein, MD (gklein@bcm.tmc.edu)Mon Mar 30 16:27:03 1998
FYI: Monday March 30 12:40 PM EST Sugar Pacifier Relieves Circumcision Pain NEW YORK (Reuters) -- Having an infant suck on a pacifier moistened with sugar water is an effective method of reducing pain during circumcision, according to researchers at the University of Chicago, Illinois. Dr. Marguerite Herschel and colleagues randomly assigned 119 baby boys to receive either no pain reliever, a dorsal penile nerve block (an injection of local anesthetic), or a sugar-dipped pacifier 2 minutes prior to circumcision. The pacifier was periodically moistened with a gauze pad dipped in 50% sugar solution, according to the report in the March issue of the Archives of Pediatrics and Adolescent Medicine. The pacifier was as effective as the nerve block during preparation for surgery, according to the infants' heart rates. Throughout most of the procedure -- until foreskin excision -- infants with the sweetened pacifier group had lower heart rates than those infants given no pain relief and showed a reduction in excessive movement associated with crying and agitation. Herschel's group notes that the American Academy of Pediatrics has not endorsed the use of dorsal penile nerve block, which carries a small risk of side effects. "We have confirmed the well-known superiority of dorsal penile nerve block for relieving the pain of circumcision," the authors wrote. "However, as a result of our findings, we recommend oral sucrose on a nipple as a safe and inexpensive method of pain relief for neonatal circumcision in the instances when either physicians or parents are not comfortable with dorsal penile nerve block." The researchers did not look at infants who were treated with topical anesthetic creams before circumcision. Such creams have to be applied an hour before the procedure, which was impossible to do in the current study because of the doctor's schedule. SOURCE: Archives of Pediatrics and Adolescent Medicine (1998;152:279-284) ---------------------------------- Geffrey H. Klein, MD ---------------------------------- gklein@bcm.tmc.edu -- ---------------------------------- List-owner OB-GYN-L
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