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February 3, 1989

Dorsal Penile Nerve Block for Circumcision-Reply

JAMA. 1989;261(5):702. doi:10.1001/jama.1989.03420050049035

In Reply.—  We appreciate the cautious comments of Drs Schoen and Fischell, but remain confident of our original findings and recommendations for more humane circumcisions.The statement that "there has been only limited experience with DPNB" is speculative and difficult to substantiate. It has been ten years since the procedure was first described and there have been multiple reports of its use from across the country, as referenced in our article. In addition, the same procedure has been used for many years by urologists for postoperative analgesia for penile surgeries and has been reported to be "safe, simple to achieve [anesthesia], and free from complications."1 Finally, our group of pediatricians has performed more than 2000 circumcisions with DPNB without any clinically significant complications noted (unpublished data).Dorsal penile nerve block minimally prolongs the length of the procedure. In practice, the child is given the injection while in his crib, examined,