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 was proposed by Broadman et al. (1987) to reduce 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
+
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=Broadman
 
  |last=Broadman
 
  |first=
 
  |first=
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}}</ref>
 
}}</ref>
  
Ring block is considered to be more effective than [[dorsal penile nerve block]] or EMLA cream.<ref name="lander1997">{{REFjournal
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Ring block is considered to be more effective than [[dorsal penile nerve block]] or [[EMLA]] cream.<ref name="lander1997">{{LanderJ etal 1997}}</ref>
  |last=Lander
+
 
  |init=J
+
{{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>}}
  |first=Janice
+
 
  |author-link=
+
The [[penis]] is innervated by both dorsal and perineal nerves,<ref name="cepeda2023">{{REFjournal
  |last2=Brady-Frerer
+
  |last=Cepeda-Emiliani
  |init2=B
+
  |first=
  |first2=Barbara
+
  |init=A
 +
  |author-link=Alfonso Cepeda-Emiliani
 +
  |last2=Gándara-Cortés
 +
  |first2=
 +
  |init2=M
 
  |author2-link=
 
  |author2-link=
  |last3=Metcalfe
+
  |last3=Otero-Alén
  |init3=JB
+
  |first3=
  |first3=James B.
+
  |init3=M
 
  |author3-link=
 
  |author3-link=
  |last4=Nazerali
+
  |last4=García
  |init4=S
+
  |first4=
  |first4=Shermin
+
  |init4=H
 
  |author4-link=
 
  |author4-link=
  |last5=Muttit
+
  |last5=Suárez-Quintanilla
  |init5=S
+
  |first5=
  |first5=Sarah
+
  |init5=J
 
  |author5-link=
 
  |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
 
  |etal=no
  |title= Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision
+
  |title=Immunohistological study of the density and distribution of human penile neural tissue: gradient hypothesis
  |journal=JAMA
+
  |trans-title=
  |location=
+
  |journal= Int J Impot Res
  |date=1997-12-24
+
  |date=2023-05-02
  |volume=278
+
  |volume=35
  |issue=24
+
  |issue=3
  |pages=2157-64
+
|article=
  |url=http://www.cirp.org/library/pain/lander/
+
|page=
 +
  |pages=286-305
 +
  |url=https://www.nature.com/articles/s41443-022-00561-9
 
  |archived=
 
  |archived=
 
  |quote=
 
  |quote=
  |pubmedID=9417009
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  |pubmedID=35501394
 
  |pubmedCID=
 
  |pubmedCID=
  |DOI=
+
  |DOI=10.1038/s41443-022-00561-9
  |accessdate=2023-11-24
+
  |accessdate=2023-12-09
}}</ref>
+
}}</ref> therefore ring block can never be totally effective.
<br>
 
{{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>}}
 
 
{{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.