Dorsal penile nerve block

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Dorsal penile nerve block (DPNB)[1] is a local anesthetic procedure sometimes used in hope of reducing pain in non-therapeutic circumcision of the newborn. In this procedure two injections of local anesthetic (lidocaine} are made near the base of the penis at the ten o'clock and two o'clock positions to block the dorsal nerves.

DPNB was proposed by Kirya & Werthman in 1978.[2] Although Kirya & Wirthman called the procedure "painless", that is an exaggeration. DPNB does block the dorsal nerves, but does not block the ventral nerves, so at best it only reduces the extreme pain of circumcision somewhat. Lander et al. (1997) did a comparison study of EMLA® cream topical anesthetic,[3] Dorsal Penile Ring Block, and Ring Block. DPNB was more effective than EMLA® cream, but less effective than ring block local anesthesia.[4]

An infant boy who is circumcised with DPNB may expect to experience pain and trauma.

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.


This video illustrates the use of DPNB.

See also

External links


  1. REFweb DPNB, The Free Dictionary by Farley. Retrieved 24 November 2023.
  2. REFjournal Kirya C, Werthman Jr MW. Neonatal circumcision and penile dorsal nerve block—a painless procedure.. J Pediatr. June 1978; 92(6): 998-1000. PMID. DOI. Retrieved 24 November 2023.
  3. REFweb Anonymous (2005). Emla cream, The Free Dictionary by Farley. Retrieved 24 November 2023.
  4. 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.