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]].<ref name="broadman1987">{{REFjournal
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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
 
  |last=Broadman
 
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  |title=Post-circumcision analgesia—a prospective evaluation of subcutaneous ring block of the penis
 
  |title=Post-circumcision analgesia—a prospective evaluation of subcutaneous ring block of the penis
 
  |trans-title=
 
  |trans-title=
  |journal= Anesthesiology
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  |journal=Anesthesiology
 
  |location=
 
  |location=
 
  |date=1987-09
 
  |date=1987-09
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  |issue=3
 
  |issue=3
 
  |pages=399-402
 
  |pages=399-402
  |url=https://watermark.silverchair.com/19870900.0-00019.pdf?
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  |url=https://pubs.asahq.org/anesthesiology/article/67/3/399/118178/Post-circumcision-Analgesia-A-Prospective
 
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}}</ref>
 
}}</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>}}
  
Ring block is considered to be more effective than [[dorsal penile nerve block]] or EMLA cream.<ref name="lander1997">{{REFjournal
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The [[penis]] is innervated by both dorsal and perineal nerves,<ref name="cepeda2023">{{REFjournal
  |last=Lander
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  |last=Cepeda-Emiliani
  |init=J
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  |first=
  |first=Janice
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  |init=A
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  |author-link=Alfonso Cepeda-Emiliani
  |last2=Brady-Frerer
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  |last2=Gándara-Cortés
  |init2=B
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  |first2=
  |first2=Barbara
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  |init2=M
 
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  |author2-link=
  |last3=Metcalfe
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  |last3=Otero-Alén
  |init3=JB
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  |first3=
  |first3=James B.
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  |init3=M
 
  |author3-link=
 
  |author3-link=
  |last4=Nazerali
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  |last4=García
  |init4=S
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  |first4=
  |first4=Shermin
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  |init4=H
 
  |author4-link=
 
  |author4-link=
  |last5=Muttit
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  |last5=Suárez-Quintanilla
  |init5=S
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  |first5=
  |first5=Sarah
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  |init5=J
 
  |author5-link=
 
  |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=
 
  |etal=no
 
  |etal=no
  |title= Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision
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  |title=Immunohistological study of the density and distribution of human penile neural tissue: gradient hypothesis
  |journal=JAMA
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  |trans-title=
  |location=
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  |journal= Int J Impot Res
  |date=1997-12-24
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  |date=2023-05-02
  |volume=278
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  |volume=35
  |issue=24
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  |issue=3
  |pages=2157-64
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|article=
  |url=http://www.cirp.org/library/pain/lander/
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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
 
  |archived=
 
  |archived=
 
  |quote=
 
  |quote=
  |pubmedID=9417009
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  |pubmedID=35501394
 
  |pubmedCID=
 
  |pubmedCID=
  |DOI=
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  |DOI=10.1038/s41443-022-00561-9
  |accessdate=2023-11-24
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  |accessdate=2023-12-09
}}</ref>
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}}</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

  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.