Anesthetic for Circumcision Urged

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)

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