How often is anesthesia used during circumcision, and how effective is its use in warding off the otherwise unbearable pain of having one's genitals probed, sliced, and cut away?
Frequency of Anesthesia
Because physicians in the United States are not required to keep records of when and how circumcision is performed, we do not have concrete numbers on the exact percentage of times anesthesia is used during infant circumcision. University of Alberta research (Edmonton, AB) estimates that the majority - 96% - of physicians in the U.S. and Canada do not using anesthesia prior to circumcision, even when parents are told otherwise.
Nursing staff in recent years have come forward (sometimes by name when they have left a job, at other times, anonymously) to admit that they typically are instructed to tell all parents their newborn babies will receive anesthesia, or "pain relief" prior to circumcision, but more often than not this is no more than a sucrose (sugar) dipped pacifier and/or topical EMLA Cream.
Sugar has been demonstrated to be ineffective in pain reduction. While this seems commonsense to adults (would you cut your genitals with a scalpel, or have amputative surgery performed on your body, while you are given nothing more than a sugary sucker?) it piggy-backs a long held myth that "babies don't feel pain." Certainly, nothing could be further from the truth. Research now confirms that while sugar in the mouth may change facial expressions during inflicted pain, it does not reduce the neurological brain response (significant cortisol spikes) that takes place, or the body responses (rapid heart rate, respiration, and occasional intense trauma responses - shock, heart failure, seizure, coma, stroke) that may occur.
Like sugar, EMLA Cream used as "pain relief," or as an anesthetic, is equally ineffective. This is yet another experiment any consenting adult can try on him/herself: rub some EMLA Cream over your genitals, or any part of your body, and make a pin prick with a needle or a slice with your razor. Feel it? So do babies - with even more intensity. In fact, not only is EMLA ineffective at blocking pain in the many dermal layers of the skin, it does nothing to block the deep and highly sensitive nerves in the penis - the majority of which are concentrated in the foreskin. And even when used in an ernest attempt to reduce pain, physicians are not waiting the recommended 1-2 hours after application of EMLA to begin cutting of the exterior layers of the penis (the only tissues that would be numbed by EMLA Cream).
In addition to its ineffectiveness, EMLA cream is not to be used on infants or the genitals of children. The EMLA Cream manufacturer's insert cautions:
EMLA is used to temporarily numb the surface of the skin. It is used for pain relief on the skin prior to procedures such as needle insertion and minor skin surgery in adults and children over 12 months of age. Its effectiveness is lessoned in children under 7 years of age.
When using EMLA Cream, it should not be applied to the following areas:
• cuts, grazes or woundsIn addition, the following warnings have been issued for professionals using EMLA cream in their practice:
• skin rashes or eczema
• in or near the eyes
• inside the nose, ear, mouth, anus
• on the genitals of children
- EMLA cream should not be applied to open wounds.
- Controlled studies of EMLA Cream in children under the age of seven years have shown less overall benefit than in older children or adults. These results illustrate the importance of emotional and psychological support of younger children undergoing medical or surgical procedures.
- During or immediately after treatment with EMLA Cream on intact skin, the skin at the site of treatment may develop erythema or edema or may be the locus of abnormal sensation.
- Blistering on the foreskin in neonates about to undergo circumcision has occurred.
- In patients treated with EMLA Cream on intact skin, local effects observed in the trials included: paleness (pallor or blanching) 37%, redness (erythema) 30%, alterations in temperature sensations 7%, edema 6%, itching 2% and rash, less than 1%.
- EMLA Cream must be applied to intact skin at least 1 hour before the start of a routine procedure and for 2 hours before the start of a painful procedure.
New to this topic? Find more: Should I circumcise my son?
Questions? You're welcome to write to SavingSons@gmail.com or join the Exploring Peaceful Parenting discussion group: www.FB.com/groups/ExplorePeacefulParenting