Infant Pain Management

[2muchHeart]

Hi everyone, I am a student and this is my first post here at allnurses. I recently witnessed a circ for the first time and only sweetease was used. It was unbearable to watch, and I can't get those cries out of my head. I know there was nothing I could do, but I feel awful that this happened to this little boy as I just stood by. My problem is not the circ itself, but the fact that it was done without anything for the pain. We wouldn't do this to a grown man, or even a dog, without something for pain, so why is it ok to do it to a helpless baby? Since 1999 the American Academy of Pediatrics has recommended using pain relief for this procedure, so I was curious if the procedures done where you work use pain relief and what kind? Are parents informed that pain relief is available for their child if they want it? And as a nurse, what can be done so that we move forward and treat infants pain just as we do adults?

[littleneoRN]

There is actually research now that shows that exposure to uncontrolled pain of "minor" procedures such as heel sticks and circumcisions has negative effects on brain development. So there is potential for long term effect, especially for infants who for various reasons are exposed to more frequent painful procedures. I think we've covered the relatively low risk pain control options, and I don't think people are suggesting opioid analgesia.

[2curlygirls]

Any doc at our facility who tried a circ with SweetEase alone would find him/herself out on their ear! Nurses would flat out refuse to assist!!!

We, as adults, would not have genital (or any other) tissue removed without some form of anesthetic. Why on earth is this acceptable for babies???

[imintrouble, BSN, RN]

I witnessed a circ 15 years ago. I'll not argue whether it was necessary or not. I only know the screams were agonizing, and I remember them to this day. Perhaps, it was a fussy baby. Maybe the restraints made the baby scream. I vowed on that day that I would not consent to that procedure on any child of mine unless adequate sedation was used. Good thing I had girls.

[SmilingBluEyes]

I cannot imagine a grown male (except in some rare cultures) allowing anyone to circumcise him without any analgesia/anesthesia! WHY, for the life of me, I will never understand, would it ever be ok for us to do this to infants, who by the way, can in no way give any sort of consent?! There may or may not be" long term consequences" that we can define at this time, but it's inhumane nonetheless.

[subee, MSN, CRNA]

Keeping in mind Circs have been done for over a thousand years without analgesia what long term consquences are there to infants that recieve circs without analgesia?

Yes, but mohels are much more adept at circumcision than physicians. Modern mohels use topical anesthetics while a little wine sucked from a finger was used for the centuries. Penile clamps are forbidden in strict Jewish law because the person using one would be considered too clumsy. A mohel takes 10 seconds. I've seen them done in the infant nursery (albeit, many years ago ) and thought it was quite barbaric.

[thomasl]

I oppose circs but if they are done it should be with as much pain control as possible that does not harm. Babies have been victums of all kinds of torture procedures based on the retarded belief they do not feel pain