Q: Circumcision pain relief?

Posted Sunday, February 17, 2008 11:03 PM

Q: What pain relief methods are available if I have my son circumcised, and how effective are they?

A: Circumcision used to be routinely formed with no anesthetic based on the mistaken belief that newborns don't feel pain. Luckily, today docs usually use anesthesia to reduce the pain -- and if yours doesn't, you can absolutely bring it up and insist upon it.

Two of the most common pain relieving techniques are the dorsal penile nerve block (DPNB) and the subcutaneous ring block. Both involve injections of lidocaine, a local anesthetic that's been found to decrease baby’s crying time by 54% and helps prevent the heart rate from spiking during the surgery. For the DNPB the lidocaine is injected at the base of the penis, and for the subcutaneous ring block, the lidocaine is injected about halfway down from the tip, underneath the skin in a ring around the penile shaft. The subcutaneous ring block has been found to provide the most effective pain relief.

EMLA cream, a topical anesthetic, is another option. The cream is spread on about half of the penis an hour to an hour and a half before the circumcision, and provides some pain relief, though not as much as the ring blocks. Studies have shown that a  pacifier or finger dipped in sugar water or brandy can help to further reduce pain.

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