Circumcision Study Ends Early Due to Infant Trauma

This study is an old one (1997) but we still find that the majority of baby boys circumcised in the United States go under the knife for surgery without anesthesia. Unfortunately, even when it is used, we are not able to eliminate the pain from the anesthesia injection (babies are at a significantly heightened level of sensitivity following birth) and even our best dorsal block injections do not numb below the perineal nerve, where the frenulum is torn back over the glans and is cut. It is no surprise that most babies scream wildly to escape the cutting, must be restrained to counter their physical attempts at escape, or they lapse into a semi-comatose state to survive the trauma.


ATLANTA (CNN) A new study found circumcision so traumatic that doctors ended the study early rather than subject any more babies to the operation without anesthesia.

The researchers discovered that for those circumcised without anesthesia there was not only severe pain, but also an increased risk of choking and difficulty breathing.

The necessity of circumcision is the subject of increasing debate, but the traditional reasons for the operations have always been prevention.

Approximately 96% of babies in the United States and Canada receive no anesthesia if and when they are circumcised, according to a report from the University of Alberta in Edmonton. [As of 2009, 32% of newborn boys born in the United States and 9% of newborn boys born in Canada undergo circumcision surgery.]

One of the reasons anesthesia is not used, the study found, is the belief that infants feel little or no pain from the procedure. It has been argued by some that injecting anesthesia can be as painful as circumcision itself, and that infants don't remember the procedure, anyway. Other physicians state that the infants do, certainly, feel the pain of genital cutting, but that it takes longer to use anesthesia, and wait for it to take effect, than it does to just do the clamping and cutting and complete the surgery.

There are, however, those who find the 'no pain' or 'no memory' reasoning difficult to believe, and Dr. Aurthur Gumer is one of them.

"To say that the baby doesn't remember it is not an adequate excuse to me," he said. "Babies experience other painful procedures to a greater degree than adults do, and we worry about that, and we do give them anesthetics for those procedures."

The Edmonton researchers, whose study was published in this week's Journal of the American Medical Association, studied the heart rates and crying patterns of babies during different stages of circumcision. Some babies were given an anesthetic, and others were not.

Rabbi Ariel Asa has performed hundreds of circumcisions. When families request it, he says he puts an anesthetic on the skin, in an effort to reduce some of the pain. But he admits it is not very effective, and there are frequent complications.

"Due to the fact that moyels (those who perform the cutting blessing in the Jewish community) do it very quickly and the pain that the baby experiences is minimal. I don't think that the overall benefits are gained [from anesthesia]," he says.

But researchers found that while topical anesthetics may help initially, they are woefully inadequate during prepuce tearing, separation and amputation.

They concluded that if circumcision must be performed, it should be preceded by an injected anesthetic that is given time to take effect.

In fact, they found the results so compelling that they took the unusual step of stopping the study before it was scheduled to end rather than subjecting any more babies to circumcision without anesthesia.


Medical Correspondent Dr. Steve Salvatore and Reuters contributed to this report.


Related Reading:

MRI Studies: Brain Permanently Altered From Infant Circumcision
Infant Pain Impacts Adult Sensitivity and Perception

Prepuce (foreskin), intact care and circumcision resources cataloged at: Are You Fully Informed?