An Evidence-Based Multidisciplinary Protocol for Neonatal Circumcision Pain Management

Authors

  • Janet Geyer RN, MSN,

    Corresponding author
    1. Janet Geyer is an advanced practice nurse, University of Iowa Hospitals and Clinics, Iowa City.
      Address for correspondence: Janet Geyer, RN, MSN, Children's Hospital of Iowa, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 2318 JCP, Iowa City, Iowa 52242-1009. E-mail: janet-geyer@uiowa.edu.
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  • Dan Ellsbury MD,

    1. Dan Ellsbury is a neonatologist with The Medical Group, Des Moines, IA. He was formerly a neonatology fellow, Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City.
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  • Charmaine Kleiber RN, PhD,

    1. Charmaine Kleiber is an advanced practice nurse, University of Iowa Hospitals and Clinics, Iowa City.
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  • Denise Litwiller RNC, BSN,

    1. Denise Litwiller is an assistant nurse manager, University of Iowa Hospitals and Clinics, Iowa City.
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  • Almira Hinton RN, MS,

    1. Almira Hinton is a nurse manager, University of Iowa Hospitals and Clinics, Iowa City.
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  • Jerome Yankowitz MD

    1. Jerome Yankowitz is an associate professor, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City.
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Address for correspondence: Janet Geyer, RN, MSN, Children's Hospital of Iowa, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 2318 JCP, Iowa City, Iowa 52242-1009. E-mail: janet-geyer@uiowa.edu.

Abstract

Pain experienced in infancy may have effects later in life. Neonatal circumcision is a common painful procedure. In addition to dorsal penile nerve block, interventions that may have a role in minimizing pain and distress in neonatal circumcision include use of a sucrose pacifier, buffered lidocaine, small needles, acetaminophen, swaddling, and environmental modification. The evidence for each intervention is presented and evaluated. Implementation of a comprehensive evidence-based circumcision pain control standard of practice is discussed.

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