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Pain
,→Intraoperative pain
4. Finally, in another, painful step, the foreskin must be cut away.
Lander ''et al''. (1997) conducted a comparison of no anesthesia (current practice), ring block, dorsal penile nerve block, and a topical eutectic mixture of local anesthetics (EMLA).
With no anesthesia, the infants cried continuously. Newborns in the untreated placebo group exhibited homogeneous responses that consisted of sustained elevation of heart rate and high pitched cry throughout the circumcision and following. Two newborns in the placebo group became ill following circumcision (choking and apnea).
EMLA was the least effective pain control. Dorsal penile nerve block (DPNB) was more effective, and ring block was the most effective. The authors reported "[w]ithout exception, newborns in this study who did not receive an analgesic suffered great distress during and following the circumcision, and they were exposed to unnecessary risk (from choking or apnea)." The authors were so alarmed that they terminated the no anesthesia arm of the study early.
None of the analgesic measures tested provided total pain relief. Any infant boy who undergoes neonatal circumcision will experience some pain and trauma. Boys who escape circumcision would have no pain or trauma. The author concluded that circumcision should be performed with anesthetic.
===Post-surgical pain===