Circumcise With Cream To Cut Tears Anesthetic Cream Also Reduced Expressions Of Pain On Faces

A study recommends that doctors routinely use an anesthetic cream to ease the pain of circumcision in newborn boys.

Typically, doctors give no pain relievers when they snip boys’ foreskins shortly after birth. Many are concerned about the hazards of analgesics, and some also believe that infants do not feel or remember pain.

The new study tested using Emla, a cream made of the anesthetics lidocaine and prilocaine, during circumcisions. Even though the cream did not eliminate all pain, boys cried less, and it appeared to be safe.

The study, conducted by Dr. Gideon Koren and others from Toronto’s Hospital for Sick Children, concluded that Emla should be used routinely during infant circumcisions.

The research was published in today’s issue of the New England Journal of Medicine and was paid for in part by Astra Pharma, which makes Emla.

An accompanying editorial by Dr. Thomas E. Wiswell of Thomas Jefferson University said the current way of doing the procedure “is still all too often barbaric.”

He said painkillers should always be given, and “parents and physicians should demand no less.”

Wiswell noted that some people oppose circumcision in part because of the pain. Nevertheless, circumcision offers clear health benefits, including fewer urinary tract infections and dramatically less penile cancer. Many believe it also lowers the risk of catching and spreading AIDS and other sexually transmitted diseases.

In the study, doctors randomly assigned 68 infants undergoing circumcision to receive Emla or a dummy cream.

Those getting Emla cried less than half as much, and while their heart rates went up, they increased 10 beats per minute less than the other babies’ did. Furthermore, their faces showed fewer expressions of pain.

Between 60 percent and 90 percent of newborn boys in the United States are circumcised.