Difference between revisions of "Ring block"

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'''{{FULLPAGENAME}}''' is the name of a nerve blocking local anesthesia procedure that is used to reduce the [[pain]] of non-therapeutic neonatal [[circumcision]].
 
'''{{FULLPAGENAME}}''' is the name of a nerve blocking local anesthesia procedure that is used to reduce the [[pain]] of non-therapeutic neonatal [[circumcision]].
  
Ring block is considered to be more effective than [[dorsal penile nerve block]] or EMLA cream.<ref name="lander1997">{{REFjournal
+
Ring block was proposed by Broadman et al. (1987) to reduce, not eliminate, the [[pain]] if a boy is to be [[circumcised]]. Broadman et al. also proposed the use of low-dose intravenous fentanyl for post-operative pain relief.<ref name="broadman1987">{{REFjournal
  |last=Lander
+
  |last=Broadman
  |init=J
+
  |first=
  |first=Janice
+
  |init=LM
 
  |author-link=
 
  |author-link=
  |last2=Brady-Frerer
+
  |last2=Hannallah
  |init2=B
+
  |first2=
  |first2=Barbara
+
  |init2=RS
 
  |author2-link=
 
  |author2-link=
  |last3=Metcalfe
+
  |last3=Belman,
  |init3=JB
+
  |first3=
  |first3=James B.
+
  |init3=AB
 
  |author3-link=
 
  |author3-link=
  |last4=Nazerali
+
  |last4=Elder
  |init4=S
+
  |first4=
  |first4=Shermin
+
  |init4=PT
 
  |author4-link=
 
  |author4-link=
  |last5=Muttit
+
  |last5=Ruttimann,
  |init5=S
+
  |first5=
  |first5=Sarah
+
  |init5=U
 
  |author5-link=
 
  |author5-link=
  |etal=no
+
|last6=Epstein
  |title= Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision
+
|first6=
  |journal=JAMA
+
|init6=BS
 +
|author6-link=
 +
  |etal=ne
 +
  |title=Post-circumcision analgesia—a prospective evaluation of subcutaneous ring block of the penis
 +
|trans-title=
 +
  |journal=Anesthesiology
 
  |location=
 
  |location=
  |date=1997-12-24
+
  |date=1987-09
  |volume=278
+
  |volume=67
  |issue=24
+
  |issue=3
  |pages=2157-64
+
  |pages=399-402
  |url=http://www.cirp.org/library/pain/lander/
+
  |url=https://pubs.asahq.org/anesthesiology/article/67/3/399/118178/Post-circumcision-Analgesia-A-Prospective
 
  |archived=
 
  |archived=
 
  |quote=
 
  |quote=
  |pubmedID=9417009
+
  |pubmedID=3307533
 
  |pubmedCID=
 
  |pubmedCID=
  |DOI=
+
  |DOI=10.1097/00000542-198709000-00019
  |accessdate=2023-11-24
+
|format=PDF
 +
  |accessdate=2023-11-25
 
}}</ref>
 
}}</ref>
  
 +
Ring block is considered to be more effective than [[dorsal penile nerve block]] or [[EMLA]] cream.<ref name="lander1997">{{LanderJ etal 1997}}</ref>
  
 +
{{Box|Boxtext=<big><b>This procedure does NOT totally eliminate [[pain]]. A baby boy will still experience some [[pain]] and [[trauma]] with this analgesic procedure. Prevention of pain requires protecting a boy from elective neonatal non-therapeutic circumcision. Only boys who are protected from the medically unnecessary, non-therapeutic circumcision surgery experience no [[pain]] or [[trauma]].</b></big>}}
 +
 +
The [[penis]] is innervated by both dorsal and perineal nerves,<ref name="cepeda2023">{{REFjournal
 +
|last=Cepeda-Emiliani
 +
|first=
 +
|init=A
 +
|author-link=Alfonso Cepeda-Emiliani
 +
|last2=Gándara-Cortés
 +
|first2=
 +
|init2=M
 +
|author2-link=
 +
|last3=Otero-Alén
 +
|first3=
 +
|init3=M
 +
|author3-link=
 +
|last4=García
 +
|first4=
 +
|init4=H
 +
|author4-link=
 +
|last5=Suárez-Quintanilla
 +
|first5=
 +
|init5=J
 +
|author5-link=
 +
|last6=García-Caballero
 +
|first6=
 +
|init6=T
 +
|author6-link=
 +
|last7=Gallego
 +
|first7=
 +
|init7=R
 +
|author7-link=
 +
|last8=García-Caballero
 +
|first8=
 +
|init8=R
 +
|author8-link=
 +
|etal=no
 +
|title=Immunohistological study of the density and distribution of human penile neural tissue: gradient hypothesis
 +
|trans-title=
 +
|journal= Int J Impot Res
 +
|date=2023-05-02
 +
|volume=35
 +
|issue=3
 +
|article=
 +
|page=
 +
|pages=286-305
 +
|url=https://www.nature.com/articles/s41443-022-00561-9
 +
|archived=
 +
|quote=
 +
|pubmedID=35501394
 +
|pubmedCID=
 +
|DOI=10.1038/s41443-022-00561-9
 +
|accessdate=2023-12-09
 +
}}</ref> therefore ring block can never be totally effective.
 
{{REF}}
 
{{REF}}
  

Latest revision as of 11:16, 9 March 2024

Ring block is the name of a nerve blocking local anesthesia procedure that is used to reduce the pain of non-therapeutic neonatal circumcision.

Ring block was proposed by Broadman et al. (1987) to reduce, not eliminate, the pain if a boy is to be circumcised. Broadman et al. also proposed the use of low-dose intravenous fentanyl for post-operative pain relief.[1]

Ring block is considered to be more effective than dorsal penile nerve block or EMLA cream.[2]


This procedure does NOT totally eliminate pain. A baby boy will still experience some pain and trauma with this analgesic procedure. Prevention of pain requires protecting a boy from elective neonatal non-therapeutic circumcision. Only boys who are protected from the medically unnecessary, non-therapeutic circumcision surgery experience no pain or trauma.


The penis is innervated by both dorsal and perineal nerves,[3] therefore ring block can never be totally effective.

References

  1. REFjournal Broadman LM, Hannallah RS, Belman, AB, Elder PT, Ruttimann, U, Epstein BS. Post-circumcision analgesia—a prospective evaluation of subcutaneous ring block of the penis PDF. Anesthesiology. September 1987; 67(3): 399-402. PMID. DOI. Retrieved 25 November 2023.
  2. REFjournal Lander J, Brady-Frerer B, Metcalfe JB, Nazerali S, Muttit S. Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision. JAMA. 24 December 1997; 278(24): 2157-64. PMID. Retrieved 24 November 2023.
  3. REFjournal Cepeda-Emiliani A, Gándara-Cortés M, Otero-Alén M, García H, Suárez-Quintanilla J, García-Caballero T, Gallego R, García-Caballero R. Immunohistological study of the density and distribution of human penile neural tissue: gradient hypothesis. Int J Impot Res. 2 May 2023; 35(3): 286-305. PMID. DOI. Retrieved 9 December 2023.