Circumcision always painful for babies

Circumcision is “one of the most painful procedures a baby can undergo”, and no fully effective anaesthetic method has yet been devised. This is the disturbing conclusion of a paper in the Italian Journal of Pediatrics, which examines the various circumcision and anaesthetic techniques in use and finds none of them satisfactory. The authors note that although “relief of human suffering is one of the most important goals for health care providers”, there have been only half-hearted efforts to eliminate the pain of circumcision, partly because the operation originated as a cultural ritual in which endurance of intense pain was part of the rationale. “Unfortunately, even during clinical trials, babies still undergo circumcision without analgesia, and the continuous production of studies for a better analgesia is the sign that a gold standard has not yet been found”, they write. The authors found that the Mogen clamp was less painful than both the Gomco clamp and the Plastibell, though seem to be unaware that the Mogen caused such a high incidence of additional injuries that a series of lawsuits drove the company out of business. It is increasingly common these days for boys to be given a local anaesthetic with a needle, but if the evidence of many Youtube videos is to be believed, the needle is itself extremely painful and often causes bleeding. EMLA cream, much vaunted by Australian circumcision salesmen, is neither effective nor recommended for use on young babies. As the authors of the present study conclude, “more research is required to find a better analgesic approach, in order to make circumcision a totally painless procedure without stress or discomfort. Present methods do not yet guarantee a total analgesia during this procedure.”

Source: Bellieni CV et al. Analgesia for infants’ circumcision. Italian Journal of Pediatrics 2013 39:38.