Pain reduction during neonatal circumcision.

PURPOSE: To determine the effect of two comfort interventions during unanesthesized circumcision on neonatal pain.

METHODOLOGY: Fifty-eight neonates were randomly assigned to one of three intervention groups. Eighteen control infants received routine care, 15 infants had music played, and 15 infants had a tape of intrauterine sounds played. During circumcision, monitors measured cardiac rate, rhythm, blood pressure, and transcutaneous oxygen. Pain was measured by analysis of videotaped facial expressions using Izard's Maximally Discriminative Facial Movement Coding System (1983).

RESULTS

Mean heart rate was above normal limits during all steps of the circumcision for the control group and during some of the steps for the other two groups. Facial expressions analyzed showed all three groups had pain much more than any other emotion during the procedure.

CONCLUSIONS

The two interventions were unable to offset the effects of circumcision pain.