Reuters, 23 December 1997.

   Tuesday December 23 6:41 PM EST

Anesthetic For Circumcision Urged

   NEW YORK (Reuters) -- Male newborns should receive an anesthetic
   before undergoing circumcision, according to a report published
this week in The Journal of the American Medical Association.

   The study was ended early for ethical reasons because part way
   through the trial it became obvious that infants who received
   anesthetic injections experienced much less discomfort and distress
   during and after circumcision.  Their heart rates were lower and
   they cried less than babies who received either anesthetic creams
   or a placebo (inactive) cream before the procedure.

   Of the 52 babies studied, two newborns in the placebo group became
   so distressed following circumcision that they were choking and had
   a hard time breathing.

   However, researchers led by Dr. Janice Lander from the University
   of Alberta in Edmonton, Alberta, Canada, note that babies who
   received any of the anesthetics studied fared better than those who
   did not receive anesthetic.

   The researchers report that the ring block type of anesthesia
   proved the most effective.  This involves injections of an
   anesthetic in a band or ring around the midpoint of the penis
   shaft. The other, less effective injection method -- dorsal penile
   nerve block -- calls for injections at two sites on the penis.

   Lander and her colleagues note that unlike the other methods, ring
   block provided anesthesia throughout all stages of the procedure,
   including foreskin separation and removal.

   The study authors note that many newborn boys who are circumcised
   in North America do not receive an anesthetic -- numbers range from
   64% to 96% in some areas. They recommend that this practice should
   change.  "It is true that as adults, these newborns will not be
   able to retrieve the memory of their surgery and distress.  This
   fact, however, cannot justify the practice of performing surgery
   without anesthetic."

   SOURCE: The Journal of the American Medical Association
   (1997;278:2157-2162)