Evaluation of Pain Management Interventions for Neonatal Circumcision Pain


Journal of Pediatric Health Care




INTRODUCTION: The purpose of the study was to determine the efficacy of music and eutectic mixture of local anesthetics (EMLA) on pain responses of neonates undergoing circumcision. METHOD: A randomized, double-blind experimental design was used with 23 neonates. Pain response was measured using an observational pain intensity rating scale and the physiologic parameters of heart rate, respiratory rate, oxygen saturation levels, salivary cortisol levels, and length of cry. Each infant's state was examined for a potential contribution to the pain response. FINDINGS: Infant state, salivary cortisol levels, and respiratory rates were not significant. Pain ratings had considerable variability for all treatment conditions, but both single treatment groups had less pain by the end of the procedure. The heart rate was significantly lower for the EMLA group and remained stable for the music group. Oxygen saturation differences were statistically significant for the music group (P =.02) and approached significance for the EMLA group. DISCUSSION: Preliminary support was provided for the efficacy of EMLA and music to contribute to the pain relief of neonates undergoing circumcision. Further study is warranted. Neonates deserve interventions that will provide them with a less painful start in life.

Music and Health Institute Terms

Cortisol Levels; Heart Rate; Infants; Mental Health; Mental Health Hormone Levels; Music Listening; Music Medicine; Neonatal Procedures; Newborn Infants; Oxygen Saturation; Pain; Pain Management and Control; Pain Score or Rating; Procedural Pain; Recorded Music Listening; Respiratory Rate; Stress; Suffering; Vital Signs

Indexed Terms

Circumcision, Male; Newborn Infants; Lidocaine; Lidocaine, Prilocaine Drug Combination; Ointments; Pain; Prilocaine

Study Type

Quasi-Experimental Study; Quantitative Methods

PubMed ID


Document Type