COMPARATIVE ASSESSMENT OF THE ANESTHETIC EFFICACY OF EMLA (EUTECTIC MIXTURE OF LOCAL ANESTHETICS) TO DORSAL PENILE NERVE BLOCK IN SUBJECTS UNDERGOING CIRCUMCISION

Abstract

Background: Objective circumcision is a common procedure performed on newborns, and it is associated with
considerable discomfort that necessitates anesthesia. While topical medications are said to have equivalent efficacy and
reduced morbidity, infiltration of local anesthetics for various procedures in neonates is linked to a number of problems.
Aim: The purpose of this study was to compare the anesthetic effectiveness of dorsal penile nerve block (DPNB) and
eutectic mixture of local anesthetics (EMLA) in participants undergoing circumcision.
Methods: Based on the type of anesthesia utilized prior to the procedure, two groups of 68 male newborns undergoing
circumcision at the institute were created. The four steps of clamping, crushing, tying, and foreskin cutting with NIPS
(neonatal infant pain scale) pain measurement were used to compare the anesthetic efficacy. Heart rate, transcutaneous
SpO2 change, and salivary cortisol levels were measured prior to and following surgery. After a day, the subjects were
evaluated for any problems.
Results: During tying and cutting (p=0.01 and 0.03, respectively), individuals from the EMLA cream group showed
significantly higher NIPS ratings. The EMLA group's heart rate increased significantly from baseline to the end of the
operation. With p=0.93 and 0.17, respectively, there was no discernible rise in heart rate in the DPNB group during
crushing and cutting. Both groups showed a considerable drop in SpO2 from baseline. In both groups, salivary cortisol
levels increased significantly. In any group, no serious complications were observed.
Conclusions: Compared to EMLA cream, dorsal penile nerve block with lidocaine provides superior pain management
for newborns undergoing circumcision. Nonetheless, dorsal penile nerve blocks and EMLA cream are both safe
treatments for newborns.