Doctors Weigh Pain In Circumcisions

More than nine in 10 doctors who are taught circumcision techniques are also now taught to take pain into consideration before circumcising a baby boy; compared with only seven in 10 a decade ago.

A new survey shows that 97 percent of these doctors now learn effective pain relief techniques for circumcision, such as using a local anesthetic.

"This is a large leap ahead in how physicians are trained to perform circumcisions, which at 1 million annually, is the most common surgical procedure," says researcher Daniel Yawman, M.D., MPH, a pediatrician at Golisano Children's Hospital at Strong and Rochester General Hospital, in a news release. "There is no reason a newborn should have to endure the pain of circumcision without a local or topical anesthetic."

Researchers say the results show that the debate over whether babies feel pain during circumcision has ended. Since 1999, most major medical associations, including the American Academy of Pediatrics, have recommended the use of anesthetics to provide pain relief for infant circumcision.

Circumcision Pain Taken Seriously

In the study, which appears in the journal Ambulatory Pediatrics, researchers surveyed more than 800 pediatrics, family practice, and obstetrics and gynecology residency programs across the U.S. in 2003. Of the programs that taught circumcision as part of their training program, 97 percent report teaching residents to ease circumcision pain with either a local or topical anesthetic.

Researchers say that's substantially higher than the 71 percent who reported training residents to treat circumcision pain in a similar survey conducted in 1995-1996.

However, there is still room for improvement. The survey also showed that pain relief techniques were used frequently or always in only 84 percent of the programs that taught circumcision.

The most common pain relief techniques used for treating circumcision pain are the dorsal penile nerve block and the subcutaneous ring block, which involve injecting the painkiller lidocaine to decrease pain.

Researchers say topical anesthetic creams are less effective at reducing pain but are safe and provide some pain relief.

SOURCES: Yawman, D. Ambulatory Pediatrics, July-August 2006; Vol. 6: pp. 210-214. News release, University of Rochester Medical Center.

By Jennifer Warner. Reviewed by Louise Chang, M.D. © 2006, WebMD Inc. All rights reserved