Circumcision: What pain relief methods are available?

I would like to know what methods are available for a painless, or at least less painful, circumcision.

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Newborn babies demonstrate measured responses to surgical procedures that are similar to those demonstrated by adults. These responses can be lessened with anesthesia. Anesthesia in general can be done by several methods including medications and behavioral techniques. These same principles may be applied to significantly reduce the pain of circumcision.

The most common anesthesia is called the dorsal penile nerve block which is when numbing medicine is placed at the nerve located at the base of the penis. This is similar to when a shot is given in the mouth prior to having dental work done. The anesthetic works during the procedure and wears off after a couple of hours. This technique has been shown to be effective in most cases. In addition to this technique, some extra things may be done further decrease pain:

  1. A relatively new topical anesthetic (called EMLA) has been used. It is a cream placed around the penis about 90 minutes prior to the procedure.
  2. Using several injections around the area where the skin will be cut. Many physicians don't like using this technique because the medicine tends to make the area swell slightly making the circumcision more difficult.
  3. Giving the infant a pacifier dipped in sugar water or a small bottle of sugar water during the procedure helps pacify and decrease pain.

Studies have shown that babies feel significant pain with circumcision, and the use of anesthesia significantly reduces and often seems to eliminate this pain. No one technique of anesthesia will work for every infant, but there are steps that can be taken to try to alleviate this pain.

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