Nerve blocks outperform topical anesthetics for neonatal circumcision pain

A network meta-analysis of 18 randomized trials (1,035 neonates) compared local anesthetic techniques for neonatal circumcision based on intraoperative physiological responses such as heart rate and oxygen saturation. The analysis found nerve blocks reduced pain-related responses compared with control and topical lidocaine, and dorsal penile nerve block outperformed EMLA cream but was associated with increased hematoma risk; meta-regression suggested smaller effect sizes in more recent studies. The authors note the evidence is based on small trials with low certainty and call for higher-quality studies.

Most relevant for: Clinicians performing or overseeing analgesia protocols for neonatal circumcision.

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