Circumcision and numbing

[cody elliott, RN]

I work for a pediatricians office and I am required to help out with infant circumcisions she uses a gomco clamp with no anesthetic what is everyone else’s experience with this and have you ever assisted with one without anesthesia what did you do and how did you cope with it all 

[Kitiger, RN]

That's how they did it 40+ years ago, when I was a student. The doctor assured me that the screaming infant was in no pain!

Yeah, right. ?

[cody elliott, RN]

1 minute ago, Kitiger said:

That's how they did it 40+ years ago, when I was a student. The doctor assured me that the screaming infant was in no pain!

Yeah, right. ?

Yea she is in her early 30s so I’m not sure why she don’t use it this day and age 

[DavidFR, BSN, MSN, RN]

Is routine circumcision still common in the US?

Medical necessity aside it's only really practised routinely in Europe for religious reasons amongst Jews and Muslims, even then not as strictly observed as it used to be. I've never known anybody be circumcised if it wasn't for religion or medical emergency.

[NRSKarenRN, BSN, RN]

 

2 hours ago, DavidFR said:

Is routine circumcision still common in the US?

YES...... 75% American men circumcised.

 

Re pain medication during procedure:

2012 American Academy of Pediatrics Releases Revised Policy on Newborn Male Circumcision

Quote

..Male circumcision should be performed by trained and competent practitioners by using sterile techniques and effective pain management.

Analgesia is safe and effective in reducing the procedural pain associated with newborn circumcision; thus, adequate analgesia should be provided whenever newborn circumcision is performed.

Nonpharmacologic techniques (eg, positioning, sucrose pacifiers) alone are insufficient to prevent procedural and postprocedural pain and are not recommended as the sole method of analgesia. They should be used only as analgesic adjuncts to improve infant comfort during circumcision

Circumcision (for Parents) - Nemours - Kids Health

Quote

...One of the hardest parts of the decision to circumcise is accepting that the procedure can be painful. In the past, it wasn't common to provide pain relief. But the American Academy of Pediatrics (AAP) recommends it and studies show that infants undergoing circumcision benefit from anesthesia, so most doctors now use it. But because this is a fairly new standard of care, it's important to ask your doctor ahead of time what, if any, pain relief your son will receive.

Two main types of local anesthetic are used to make the operation less painful for a baby:

• a topical cream (a cream put on the member) that requires at least 20 to 40 minutes to take its full effect
• an injectable anesthetic that requires less time to take effect and may provide a slightly longer period of anesthesia

In addition to anesthesia, acetaminophen is sometimes given. This helps reduce discomfort during the procedure and for several hours afterward. Giving a pacifier dipped in sugar water and swaddling a baby also can help reduce stress and discomfort....

 

 

[DavidFR, BSN, MSN, RN]

1 hour ago, NRSKarenRN said:

 

YES...... 75% American men circumcised.

Why??????

[NRSKarenRN, BSN, RN]

From the Nemours link above:
 

Quote

 

Approximately 55% to 65% of all newborn boys are circumcised in the United States each year, though this rate varies by region (western states have the lowest rates and the north central region has the highest). The procedure is much more widespread in the United States, Canada, Africa, and the Middle East than in Asia, South America, Central America, and most of Europe, where it's uncommon.

Parents who choose circumcision often do so based on religious beliefs, concerns about hygiene, or cultural or social reasons, such as the wish to have their son look like other men in the family.

 

 

[Workitinurfava, BSN, RN]

As a pca (patient care assistant), I assisted doctors with circumcisions and I did see an injection put around the member area to block pain. I believe lidocaine was used. There was also sugar water put on a pacifier, and the baby would suck on it. Most babies screamed like he'll though, when the circumcision was performed.

[CommunityRNBSN, BSN, RN]

On 3/26/2021 at 11:55 PM, DavidFR said:

Why??????

It is a cultural norm. Hopefully we can all be respectful of cultural norms, can we not?  If not, believe me, there are TONSSS of Reddit boards where you can share your horror and disgust. (Also my son isn’t circumcised, so I’m not some sort of circumcision advocate. But I’d hate for this thread to descend into xenophobia where you insist only barbarians would do such a thing.) 

[klone, MSN, RN]

I think there is room to explore the why's of cultural norms and suggest that cultures can change. The biggest cultural reason that parents in the US choose to circ their son is "I want him to look like me" and "Because everyone does it."

That's a crappy reason to do an elective surgical procedure on a newborn infant. Personally speaking, I have 2 sons - my 23yo is circed. My 13yo is not. You know better, you do better. Cultures can change.

OP, I responded to your post in the OB/Gyn thread about this, but I will say it again - performing a circ without anesthesia of any kind is barbaric. I've been an RN for 15 years, and in that 15 years, it's always been the standard of care to provide a penile nerve block with lidocaine, and Sweetease on a pacifier.

[SmilingBluEyes]

My son was circ'd 29 years ago But if I had given birth to  him today, I would not do it. I know better; I would do better. But that is just me.

[HiddencatBSN, BSN]

On 3/26/2021 at 11:55 PM, DavidFR said:

Why??????

Cultural bias that it’s the norm. When I was on pregnancy message boards the number one reason I saw was so that the baby would look like the dad.