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Table 1 Papers meeting the inclusion criteria, collected in chronological order

From: Analgesia for infants’ circumcision

Authors article Newborns Analgesia Surgical technique Pain scale Results Pub date
O’Sullivan et al. [17] 66 DPNB (ultrasound or anatomical landmark) / fentanyl ukn* FLACC No significant difference between the groups in terms of fentanyl administration. The ultrasound technique took longer to perform but suggests some benefits in terms of postoperative pain. 2011
Banieghbal et al. [18] 583 RB/milk Gomco NIPS RB causes a painful response in the majority of the babies, but this is mostly noted in babies over one week of age. 2009
Lehr et al. [19] 44 DPNB/EMLA/lidocaine Gomco NFCS/crying time No significant difference in analgesic efficacy between treatments. 2007
Garry et al. [20] 18 DPNB/EMLA ukn* NIPS/numeric pain scale DPNB is significantly more effective for pain relief than topical EMLA. 2006
Lehr et al. [21] 53 DPNB/EMLA/lidocaine Gomco Heart rate/respiratory rate/SpO2 No significant difference in analgesic efficacy between treatments. 2005
South et al. [22] 44 DPNB/Tylenol/non-nutritive sucking Gomco PIPP/crying time/ salivary cortisol level NNS significantly decreases the pain response, in addition to other common analgesics. 2005
Razmus et al. [23] 132 DPNB/DPNB+sucrose/ DPNB+sucrose+EMLA/ EMLA/ EMLA+sucrose/ RB/ RB+sucrose solution/ sucrose solution ukn* FLACC DPNB and RB in combination with the concentrated oral sucrose have the lowest pain scores. The sucrose alone does not provide sufficient analgesia; however, it can reduce the pain scores somewhat when used in conjunction with other analgesics. 2004
Malnory et al. [24] 53 Acetaminophen Gomco NIPS Lower pain scores in newborns who received analgesia than placebo. 2003
Taeusch et al. [25] 59 DPNB/dextrose solution Mogen vs PlastiBell Cry response The Mogen technique is preferred over the PlastiBell because of the simplicity of execution, and it is also associated with less pain and discomfort and it takes less time. 2002
Kaufman et al. [26] 57 EMLA/sucrose solution Mogen vs Gomco Crying time/ facial grimancing Mogen appears a better procedure than Gomco, and it takes less time, showing also that the use of analgesia is imperative. 2002
Macke et al. [27] 60 Acetaminophen Gomco NCAFS/crying time/heart rate No significant difference in analgesic efficacy between treatments and placebo. 2001
Joyce et al. [28] 23 EMLA/music ukn* RIPS/heart rate/SpO2/salivary cortisol level/crying time Efficacy of EMLA and music to contribute to the pain relief of neonates undergoing circumcision. 2001
Kass et al. [29] 71 DPNB/dextrose solution Gomco MBPS/ crying time/heart rate/respiratory rate No significant differences between the oral glucose and water groups among any of the pain-related measurements; only the use of DPNB shows significantly lower pain scores and reduced objective measurements of pain and physiologic stress. 2001
Taddio et al. [30] 86 DPNB/EMLA/acetaminophen Mogen vs Gomco NFCS/crying time Infants circumcised with the Mogen clamp and combined analgesia have also less pain than those circumcised with the Gomco clamp and EMLA cream, and it also takes less time. 2000
  1. *No data was available regarding the specific surgical procedure to perform MC.
  2. Abbreviations: NIPS Neonatal infant pain scale, RIPS Riley infant pain scale, PIPP Premature infant pain profile, MBPS Modified behavioral pain scale, NFCS neonatal face coding system, NCAFS nursing child assessment feeding scale, DPNB Dorsal penile nerve block, RB Ring block.