Evidence map›Paper›PMID 42624889›Full record

ArticleJournal of perinatology : official journal of the California Perinatal Association2026

Local anesthetic techniques for analgesia in neonatal circumcision: a network meta-analysis.

Gabriel Lemos González, Gustavo Roberto Minetto Wegner, Bruno Francisco Minetto Wegner, Iaci Luisa Lopes de Mattos, Catherine Maria Fasano Werner, Fani Nhuch, Vitor Alves Felippe, Tatiana Souza Nascimento

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Article in Journal of perinatology : official journal of the California Perinatal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Gabriel Lemos GonzálezFederal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil.ORCID http://orcid.org/0009-0005-1788-8514
Gustavo Roberto Minetto WegnerFederal University of Fronteira Sul, Rio Grande do Sul, Brazil.
Bruno Francisco Minetto WegnerFederal University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
Iaci Luisa Lopes de MattosFederal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil.ORCID http://orcid.org/0009-0000-8256-5811
Catherine Maria Fasano WernerState University of Londrina, Paraná, Brazil.
Fani NhuchUniversity of Washington, Seattle, USA.ORCID http://orcid.org/0009-0003-7990-9451
Vitor Alves FelippeBrazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil.
Tatiana Souza NascimentoUniversity of Iowa, Iowa City, IA, USA. tatiana-nascimento@uiowa.edu.ORCID http://orcid.org/0009-0002-6897-1463

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveNeonatal circumcision is often performed without adequate analgesia despite significant harm related to acute pain. We compared local anesthetic techniques using network meta-analysis based on intraoperative physiological responses. STUDY

designFrequentist network meta-analysis of randomized controlled trials comparing nerve blocks (dorsal penile nerve block, DPNB; ring block, RB), topical anesthetics (eutectic mixture of local anesthetics, EMLA; topical lidocaine, TL), combination techniques, and control. OUTCOMES: intraoperative heart rate, oxygen saturation, their variation, respiratory rate, and hematoma. Risk of bias and certainty of evidence were assessed.

resultsEighteen trials (1 035 neonates) were included. Nerve blocks reduced pain-related responses versus control and TL. DPNB outperformed EMLA, with increased hematoma risk. Meta-regression suggests smaller effect size in recent studies.

conclusionsEvidence supports local anesthetic techniques for neonatal circumcision, with nerve blocks providing greater benefit than topical anesthetics. However, given the small sample sizes and low certainty of evidence, higher-quality trials are needed.

Identifiers

PMID42624889

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.