Analgesic efficacy of using topical anesthetic before dorsal penile nerve block in infant circumcision: A randomized-controlled study

Objectives: The aim of this study was to investigate the effect of lidocaine-prilocaine cream (LPC) application on circumcision analgesia and algology before dorsal penile nerve block (DPNB). Patients and methods: Between January 2024 and April 2024, a total of 128 healthy male infants aged 1 to 12 months, who were screened and underwent circumcision under local anesthesia in our clinic, were included in this randomized-controlled study. The patients were divided into two groups as the DPNB group (DPNB group, n=64) and the DPNB+LPC group (n=64). The heart rate (HR), respiratory rate (RR), peripheral arterial oxygen saturation (SpO 2 ) changes, and Neonatal Infant Pain Scale (NIPS) scores were measured during the surgical stages of the groups with and without topical analgesia before DPNB. The values at the time of DPNB injection, at the time of circumcision, and at 3 min after the end of the operation were recorded. Results: There was no statistically significant difference in the mean age and body weight of the patients between the groups (p>0.05). There was also no statistically significant difference between the HR, RR, and SpO 2 of the groups before the operation (baseline), at the time of local analgesic needle insertion, during circumcision and after the operation (p>0.05). The NIPS scores at the time of local anesthetic needle insertion were significantly different (p=0.04), although there was no significant difference in the NIPS scores at the other time points (p>0.05). Conclusion: Our study results suggest that LPC application before DPNB yields favorable effects in terms of local anesthesia and ease of surgery, and it is a safe technique to apply.