If you have your child circumcised, it's important to remember that he will feel pain, and that Acetaminophen (such as Tempra or Tylenol) or EMLA cream, which numbs the skin, will not be adequate to dull surgical pain. "Analgesia is safe and effective in reducing the procedural pain associated with circumcision and, therefore, adequate analgesia should be provided if neonatal circumcision is performed." Circumcision Policy Statement (RE9850), AAP 1999.
There are several ways to circumcise. Studies show that the amount of pain your child endures depends on the type of circumcision that is performed. The Mogen clamp seems to cause the least amount of pain compared to the Plastibell, or Gomco techniques.
EMLA cream should be used to reduce the pain of a local anesthetic (subcutaneous ring block, or dorsal penile nerve block) that is given by needle in the area where the circumcision is done.
Lidocaine is injected just under the skin in a ring around the shaft of the penis, about halfway back from the tip. Recent evidence suggests that it is more consistently powerful in preventing pain through all phases of the circumcision than either EMLA or dorsal penile nerve block. The needle can cause bruising and swelling, and the anesthetics can have risks.
DNPB involves two deep injections of lidocaine at the base of the penis. Despite the shots, this technique greatly reduces overall pain.
Your child should be given acetaminophen when the local anesthetic wears off. He should receive it for 48 hours, or longer if he is still uncomfortable. Studies have shown that a pacifier or piece of gauze soaked with a sugar solution can be given to your baby, which may help ease the post-surgery pain.
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