Ambulatory Pediatrics, Volume 6, Issue 4: Pages 210-214, 1 July 2006.
Daniel Yawman, MD, MPH¹, Cynthia R. Howard, MD, MPH¹; Peggy Auinger, MS¹; Lynn C. Garfunkel, MD¹; Marjorie Allan, BS²; Michael Weitzman, MD³
¹ Department of Pediatrics, 
University of Rochester, School of Medicine and Dentistry and Golisano Childrens Hospital at Strong, Rochester, NY
² Department of Pediatrics, Rochester General Hospital, Rochester, NY
³ AAP Center for Child Health Research, Rochester, NY
Objective
To assess current training practices regarding the provision of effective analgesia for routine newborn circumcision.
Methods
All family practice (FP), obstetric and gynecologic (OB/GYN), and pediatric (PED) residency program directors in the United States received a mailed survey in 2003 (N = 940).
Results
Survey responses were received from 86% (811/940) of the programs (FP 88%, OB/GYN 82%, and PED 87%). Eighty-two percent (669/811) of all programs surveyed taught circumcision (FP 95%, OB/GYN 89%, and PED 49%). Of programs that taught circumcision, 97% (648/669) taught the administration of an anesthetic, either locally or topically. This proportion is significantly higher than that reported in 1998 (71%, 374/527; P < .001). However, of these same programs that taught circumcision, the anesthetic techniques were used frequently or always in only 84%.
Conclusions
The percentage of training programs that teach effective analgesia for neonatal circumcision increased dramatically since the time of the previous data collection. Despite this improvement in teaching practices, some training programs may not consistently use effective analgesia for neonatal circumcision.
Key words: circumcision, newborn, pain, residency
Received 7 September 2005; accepted 13 April 2006
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