"I don't know the specific name of the medication the doctors used to numb, but I know it works, because I watched one little boy sleep through his circumcision!"
It is called lidocaine--and it only REDUCES the pain..
"In summary, analgesia is safe and effective in REDUCING the procedural pain associated with circumcision " (emphasis added) http://aappolicy.aappublications.org...rics;103/3/686
EFFECT OF NEONATAL CIRCUMCISION ON PAIN RESPONSE
THE LANCET, Volume 349 Number 9052: Pages 599-603, March 1, 1997.
Meritcare (Internet) states that "Besides anesthesia, securing your child in the padded restraint chair and giving him a sugar-dipped pacifier can help reduce his level of stress (and yours). Used together, these methods can decrease discomfort by more than 50%." http://www.meritcare.com/kidshealth/...77&lic=19&pg=3 http://www.nichd.nih.gov/cochrane/Br...BRADYFRYER.HTM
None of the studied interventions completely eliminated the pain response to circumcision
As for when it is used, what didn't you understand about the rate of usage I posted above.
Sleep through it?
HARM CAUSED BY CIRCUMCISION
The increasing doubts about Jewish circumcision are based on the understanding that it causes harm. Anatomical, neurochemical, physiological, and behavioral studies confirm what mothers already know: infants feel pain. Drs. Anand and Hickey, in a comprehensive review of recent medical literature on newborn pain, conclude that newborn responses to pain are "similar to but greater than those in adult subjects."11 This study is accepted by virtually all medical authorities and is often cited in the literature whenever there is a discussion of infant pain. As a surgical procedure, circumcision has been described as "among the most painful performed in neonatal medicine."12 Studies of infant responses show that the pain of circumcision is not like that of a mere pin prick. It is severe and overwhelming.
The relationship between infant pain and vocal response needs explanation. The cry may be reduced by the effect of anesthetics given to the mother during labor.13 These anesthetics enter the infant's body and, according to pediatrician T. Berry Brazelton, it can take over a week to leave.14 Other factors can also account for minimal vocal response. Justin Call, infant psychologist and professor-in-chief of child and adolescent psychology at the University of California, reports that "sometimes babies who are being circumcised . . . . lapse into a semi-coma."15 Tonya Brooks, president of the International Association for Childbirth at Home and a midwife, observes, "In four of the nine circumcisions that I have seen, the baby didn't cry. He just seemed to be suddenly in a state of shock!"16 Studies demonstrate that even though an infant may not cry during circumcision, the stress hormone level in the blood still increases dramatically, and medical researchers consider this change to be the most reliable indicator of pain response.17 Therefore, lack of crying does not mean that the infant feels no pain. It could mean that he is withdrawing from unbearable pain. http://www.circumcision.org/spectator.htm http://www.cirp.org/pages/parents/circ-why/
PAIN, STRESS AND RISKS
Until recently it was believed babies felt no pain due to their immature nervous systems. Studies however, indicate that babies experience physical and psychological stress both during the circumcision and for hours thereafter. The procedure is undeniably painful. Some babies cease to cry or lapse into a deep sleep or coma which is how they are able to cope with the traumatic experience.
Some babies are so severely traumatized by the experience that they fall into a semicomatose state. Some circumcisers still pretend that these babies are just falling asleep! Nothing could be further from the truth. No one falls asleep when his sex organs are being cut with a knife. Because he is tied down, a baby has no way to escape, no matter how much he thrashes. Going into a comalike state is one way for the baby to distance himself from his agony, but it has dangerous consequences for the brain, as you will read below. http://www.nospank.net/fleiss1.htm
"They are most likely NOT crying because they are in pain. The initial poke of the injection causes some discomfort. The nurses I watched all had a pacifier with sugar water ready because glucose (sugar) is shown to have an analgesic effect on infants."
I can't believe medical people are still trying to use this tired old rationale. http://www.cirp.org/news/cin/1995.04.12
993; 270: 850-53 [Benni F et. al] Their study confirmed the permanent psychological damage inflicted on infants subjected to unanesthetised penile reduction surgery. The severe and unalleviable pain of circumcision permanently alters the neural pathways in an adverse fashion. From JAMA 1988; 259: 1507-11 [Stang HJ, et. al] They found that an injection of lignocaine hydrochloride reduced the plasma cortisol concentration slightly, but left the babies with a concentration of 331nmol/L, whereas a content infant at rest has a plasma cortisol concentration of 28-138 nmol/L. Sadly, the Benni group found that EMLA (lignocaine/prilocaine local anesthetic cream) could only reduce the circumcised child's heartbeat from 180 to 160 beats a minute. No infant's heart should beat at 160 beats a minute, nor should his plasma cortisol concentration be 331 nmol/L. These rates are consistent with torture. With or without anesthetic circumcision will cause psychoneural damage.
Note: the change in the heartbeat rate is 60 bpm.
The above values includes this increase. Therefore the delta rate of 60 must be added to ANY resting rate to determine the absolute values. Then the comparison of rates can be done with other procedures.
PEDIATRICS, Volume 71 Number 1, Pages 36-40,
Physiologic Stress Reduction by a Local
Anesthetic During Newborn Circumcision
Paul S. Williamson, MD, FAAFP, and Marvel L. Williamson, RN, MSN http://www.cirp.org/library/pain/williamson/ http://www.cirp.org/library/anatomy/cold-taylor/
Although most neonatal and childhood circumcisions are performed with no anaesthesia , the complicated innervation of the penis explains why a dorsal penile nerve block provides incomplete pain relief for neonatal male circumcision [37,38].
Likewise, a penile ring block cannot block the visceral afferent fibres from the cavernosal nerve nor the posterior scrotal somatosensory branches of the perineal nerve . A eutectic mixture of local anaesthetic cream (EMLA) does not relieve the pain associated with circumcision because of the complexity of penile innervation and the multiple layers that would have to be penetrated by the topical cream in the newborn penis . Amazingly, some modern urology textbooks even recommend wine as an anaesthetic for newborn circumcision .
"Pain and its Effects in the Human Neonate and Fetus." By K.J.S. Anand & P.R. Hickey. New England Journal of Medicine, November 19, 1987. Page 1325 states: "Most recently the motor responses of 124 healthy full-term neonates to a pinprick in the leg were reported to be flexion and adduction of the upper and lower limbs associated with grimacing, crying, or both, and these responses were subsequently quantified. Similar responses have also been documented in very premature neonates, and in a recent study, Fitzgerald et al. found that premature neonates (<30 weeks) not only had lower thresholds for a flexor response but also had increased sensitization after repeated stimulation." Page 1325 states: "In other studies of the cry response to painful procedures, neonates were found to be more sensitive to pain than older infants (those 3 to 12 months old)…" This article uses the obstetric method of counting from the last menstrual period, as evidenced by the chart on page 1322, which uses a gestation of 40 weeks for pregnancy. Two weeks must be subtracted to provide the actual time since fertilization.
"Symptom Management: Acute Pain, Chapter 3 - Pain in Preverbal Children." United States National Institutes of Health, Publication Number 94-2421. June 1994.
Accessed at http://www.nih.gov/ninr/research/vol6/preverbal.pdf
in September of 2002. Page 2 cites one possible reason why younger humans are more sensitive to pain: "Serotonin (5HT) is a biogenic amine transmitter that serves an important role in pain modulation. … Serotonin levels in the young infants are low and may limit the effectiveness of the endogenous pain control mechanisms (Fitzgerald 1991b)."