Circumcision and Pain?

Specialties Ob/Gyn

Published

Ok so witnessed my first circumcision the other day.

I have to say...I hope I don't have to see another. The doctor used nothing for pain while he put hemastats and cut the babys foreskin. The baby was screaming..and all I could give him was a pacifer with sugar? Seriously??

Is this common practice?

Specializes in Adult/Ped Emergency and Trauma.

@Sucrose Answers- Thanks Guys:)

It's evidence based practice - oral sucrose releases endorphins that helps with pain management. In many NICUs, sucrose on pacifiers is given during any stressful or painful procedure.

We also used sucrose during PKU and bili pokes in post partum and I do all my Vit K injections (and did heel pokes at my old job) with the baby skin to skin and feeding as colostrum provides a similar pain effect!

Hmmm next time I get a paper cut, or slice open my finger while cutting something with a knife, I'm going to down some chocolate and see if it takes the pain away, lol. Absurd.[/quote']

Binds to opiate receptors I believe. There is a similar effect to morphine in babies for the first (?8-12 weeks I want to say?) after birth and then they build a tolerance to it.

It's pretty well researched. Whether it is appropriate for the pain from circumcision is another matter, but sucrose for pain relief in neonates (which I presume you are not) has a body of evidence behind it. And anecdotally, I've seen it make a difference in pain from heel sticks and IVs.

What *I* find absurd (and a little sad) is that you've projected your guilt about circing your older son on to him to the extent that it sounds like he has body image issues about it. I'm no supporter of circumcision, but I have to wonder whose needs are being served there.

I know, I've read some articles on the sucrose. And I do support it. However, heel sticks are a big difference then a procedure such as a circumcision, don't ya think? No worries about my son....I haven't projected my guilt at all. We simply explained to him the difference between him and his brother. He's 9, he has common sense enough to know that putting a knife to a member doesn't sound like a good idea. I didn't need to put that thought in his head at all. And like I said, he doesn't dwell on the fact that he doesn't have a foreskin. He knows, we made a mistake and we did what we thought had to be done at the time. It's just every once in awhile he'll bring it up as a joke....and I'm not talking about every day, it's more like every couple months. It's not something we frequently talk about, lol.

I'm unclear - what exactly are you saying is absurd?

Absurd that doctors use sucrose for pain relief such as that endured by a circumcision.

Specializes in NICU, PICU, PACU.

Was there EMLA cream applies before that you didn't know about? We use either EMLA or lidocaine, depending on the OB recommendation. We also give Tylenol when they start and for 24 hours after. Your practice committee needs to take a serious look at this.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Absurd that doctors use sucrose for pain relief such as that endured by a circumcision.

It *should* be simply one of several pain relief measures used, *including* a dorsal penile nerve block. But it should not be discounted as an ineffective method, just as massage or music should not be discounted as an effective tool for pain relief during childbirth, even though those methods alone are not going to take away a woman's pain entirely.

Specializes in L&D.

Nope I took the baby back to the nursery for the procedure and didnt leave his side. No cream was applied.

Was there EMLA cream applies before that you didn't know about? We use either EMLA or lidocaine, depending on the OB recommendation. We also give Tylenol when they start and for 24 hours after. Your practice committee needs to take a serious look at this.
Specializes in Nephrology, Cardiology, ER, ICU.

Okay - now back to the topic: pain relief during circumcision. This is NOT a debate as to the rightness or wrongness of circumcision - please stay on topic. Thanks.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

The AAP's current policy statement is that all infants should have adequate pain management during and after the procedure. ACOG agrees with the AAP and states that "pain control should be provided. Swaddling, oral sugar solutions, or acetaminophen may be given as well, but should not be used as the primary method of pain relief."

American Academy of Pediatrics Task Force on Circumcision. Circumcision policy statement. Pediatrics 2012; 130:585.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

I think we need to start a new thread if we want to debate circ itself :/

Specializes in L&D.

If you wanna...I honestly just started the thread wanting to know if just usung the sucrose and Tylenol afterwards was the usual practice..

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