Abstract:
Introduction: Neonatal circumcisions are commonly performed in Nigeria, most often without anesthesia. The aim of this study was to
determine whether anesthesia was required for neonatal circumcision. Materials and Methods: All new-born male neonates presenting for
routine circumcision were considered for inclusion in the study. This was a randomized control study, comparing pain scores during circumcision
with local anesthesia or without local anesthesia. A total of 72 neonates were randomly assigned to the two groups using computer-generated
random numbers, with 36 in each group. The neonates were not matched for age or weight. All the anesthetic procedures and circumcisions
were performed in identical manner by the principal investigators using the plastic bell technique. Approval for the study was obtained
from the Research Ethics Committee of the hospital. Written voluntary informed consent was obtained from the parents of the neonates.
Results: The mean age and weight of the neonates in the study were 17 ± 2 days and 3.2 ± 0.68 kg, respectively. The mean Neonatal/Infant
pain score was 4.8 in the local anesthesia group and 6.0 in those without anesthesia. The mean transcutaneous PO2
was 90.47 ± 7.53 in those
with anesthesia compared to 85.83 ± 5.61 in those without anesthesia. The mean heart rate was 133.88 ± 35.00 beats/min in the anesthesia
group compared to 152.11 ± 79.80 in those without anesthesia. Neonates circumcised without local anesthesia had higher respiratory rate
compared to those circumcised with local anesthesia. Conclusion: Neonates circumcised without local anesthesia had higher mean pain
scores, heart rate, lower oxygen saturation and increased mean respiratory rate than those that had local anesthesia. Local anesthesia should
be routinely used during neonatal circumcision.
