Inadequate Pain Control

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• Most often due to poor dorsal penile nerve block technique.

• Review of proper location and depth of needle tip (see section Penile Nerve Block Analgesia > Anatomy of Dorsal Penile Nerves).

• Avoid moving the needle location during aspiration or injection. Steadying the hand or wrist on the restraining board is helpful.

• Use proper technique for the ventral subcutaneous infiltration of the perineal nerves (see section Penile Nerve Block Analgesia > Ventral Subcutaneous Injection Technique).

• Wait at least three minutes before proceeding with the circumcision. During this time apply the iodophor ("Betadine") solution and prepare the circumcision pack.

• Use adjunctive measures such as 24% sucrose solution on a pacifier for comfort.

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