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 | + | 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= | + | |last=Broadman |
| − | | | + | |first= |
| − | | | + | |init=LM |
|author-link= | |author-link= | ||
| − | |last2= | + | |last2=Hannallah |
| − | | | + | |first2= |
| − | | | + | |init2=RS |
|author2-link= | |author2-link= | ||
| − | |last3= | + | |last3=Belman, |
| − | | | + | |first3= |
| − | | | + | |init3=AB |
|author3-link= | |author3-link= | ||
| − | |last4= | + | |last4=Elder |
| − | | | + | |first4= |
| − | | | + | |init4=PT |
|author4-link= | |author4-link= | ||
| − | |last5= | + | |last5=Ruttimann, |
| − | | | + | |first5= |
| − | | | + | |init5=U |
|author5-link= | |author5-link= | ||
| − | |etal= | + | |last6=Epstein |
| − | |title= | + | |first6= |
| − | |journal= | + | |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= | + | |date=1987-09 |
| − | |volume= | + | |volume=67 |
| − | |issue= | + | |issue=3 |
| − | |pages= | + | |pages=399-402 |
| − | |url= | + | |url=https://pubs.asahq.org/anesthesiology/article/67/3/399/118178/Post-circumcision-Analgesia-A-Prospective |
|archived= | |archived= | ||
|quote= | |quote= | ||
| − | |pubmedID= | + | |pubmedID=3307533 |
|pubmedCID= | |pubmedCID= | ||
| − | |DOI= | + | |DOI=10.1097/00000542-198709000-00019 |
| − | |accessdate=2023-11- | + | |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 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
- ↑
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 
. Anesthesiology. September 1987; 67(3): 399-402. PMID. DOI. Retrieved 25 November 2023.
- ↑ 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.
- ↑ 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.
