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]].
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''{{FULLPAGENAME}}''' is a nerve blocking local anesthesia procedure that is used to reduce the [[pain]] of non-therapeutic neonatal [[circumcision]].
 
  
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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
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|last=Broadman
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|first=
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|init=LM
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|author-link=
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|last2=Hannallah
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|first2=
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|init2=RS
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|author2-link=
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|last3=Belman,
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|first3=
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|init3=AB
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|author3-link=
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|last4=Elder
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|first4=
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|init4=PT
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|author4-link=
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|last5=Ruttimann,
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|first5=
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|init5=U
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|author5-link=
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|last6=Epstein
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|first6=
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|init6=BS
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|author6-link=
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|etal=ne
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|title=Post-circumcision analgesia—a prospective evaluation of subcutaneous ring block of the penis
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|trans-title=
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|journal=Anesthesiology
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|location=
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|date=1987-09
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|volume=67
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|issue=3
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|pages=399-402
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|url=https://pubs.asahq.org/anesthesiology/article/67/3/399/118178/Post-circumcision-Analgesia-A-Prospective
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|archived=
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|quote=
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|pubmedID=3307533
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|pubmedCID=
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|DOI=10.1097/00000542-198709000-00019
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|format=PDF
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|accessdate=2023-11-25
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}}</ref>
  
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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>
  
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{{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>}}
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The [[penis]] is innervated by both dorsal and perineal nerves,<ref name="cepeda2023">{{REFjournal
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|last=Cepeda-Emiliani
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|first=
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|init=A
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|author-link=Alfonso Cepeda-Emiliani
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|last2=Gándara-Cortés
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|first2=
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|init2=M
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|author2-link=
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|last3=Otero-Alén
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|first3=
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|init3=M
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|author3-link=
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|last4=García
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|first4=
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|init4=H
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|author4-link=
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|last5=Suárez-Quintanilla
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|first5=
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|init5=J
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|author5-link=
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|last6=García-Caballero
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|first6=
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|init6=T
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|author6-link=
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|last7=Gallego
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|first7=
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|init7=R
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|author7-link=
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|last8=García-Caballero
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|first8=
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|init8=R
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|author8-link=
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|etal=no
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|title=Immunohistological study of the density and distribution of human penile neural tissue: gradient hypothesis
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|trans-title=
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|journal= Int J Impot Res
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|date=2023-05-02
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|volume=35
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|issue=3
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|article=
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|page=
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|pages=286-305
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|url=https://www.nature.com/articles/s41443-022-00561-9
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|archived=
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|quote=
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|pubmedID=35501394
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|pubmedCID=
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|DOI=10.1038/s41443-022-00561-9
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|accessdate=2023-12-09
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}}</ref> therefore ring block can never be totally effective.
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{{REF}}
  
 
[[Category:Circumcision]]
 
[[Category:Circumcision]]
 
[[Category:Pain]]
 
[[Category:Pain]]
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[[Category:Medical term]]

Latest revision as of 12:16, 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.
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