Comparison of local anesthetic effects of lidocaine versus tramadol and effect of child anxiety on pain level in circumcision procedure

• Published in: Journal of pediatric urology Vol. 9; no. 5; pp. 670 - 674
• Main Authors: Polat, Fazli, Tuncel, Altug, Balci, Melih, Aslan, Yilmaz, Sacan, Ozlem, Kisa, Cebrail, Kayali, Mustafa, Atan, Ali
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2013
• Subjects: Anesthetics, Local - therapeutic use; Anxiety; Child; Circumcision; Circumcision, Male; Humans; Lidocaine - therapeutic use; Local anesthesia; Male; Pain; Pain, Postoperative - prevention & control; Pain, Postoperative - psychology; Parents - psychology; Pediatrics; Tramadol - therapeutic use; Urology; Anxiety; Pain; Child; Circumcision; Local anesthesia
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2012.07.022

Abstract Objective To compare the local anesthetic effects of tramadol hydrochloride with those of lidocaine in circumcision procedures. We also investigated the effect of child anxiety on pain level. Patients and methods A total of 70 children were included in this study. The children were randomized into 3 groups. Group 1 ( n  = 26) received lidocaine hydrochloride + epinephrine and they underwent circumcision using Ali's clamp® . Group 2 ( n  = 35) received lidocaine hydrochloride + epinephrine and group 3 ( n  = 12) 5% tramadol. The last two groups underwent conventional circumcision. Results The mean anxiety score was 22.6. We did not find significant differences in terms of anxiety score among the groups ( p  = 0.761). When the pain scores of the groups during injection were compared, it was found that there were no significant differences. However, the pain score of the third group was significantly high when it was compared with the first and second group 2 and 10 min after injection. In the correlation analysis, we found a positive correlation between children's anxiety scores and the pain degree during injection ( r  = 0.373, p  = 0.001). Conclusion Tramadol may not provide effective local anesthesia in male circumcision. The child's anxiety before the circumcision seems to have a negative effect on pain level.