Changes

'''EMLA''' ointment is an acronym for Eutectic Mixture of Local Anesthetic.<ref>{{REFweb |url=https://medical-dictionary.thefreedictionary.com/EMLA |title=EMLA |last=Anonymous |first= |init= |publisher=The Free Dictionary by Farlex. |date=2008 |accessdate=2023-11-30}}</ref> EMLA Cream is a trademarked brand of topical local anesthetic.''Eutectic'' means that the melting point of the combination is less than that of the ingredients.<ref>{{REFweb |url=https://en.wikipedia.org/wiki/Eutectic_system |title=Eutectic system |last= |first= |init= |publisher=Wiipedia |date= |accessdate=2023-11-30}}</ref>

The combination of the topical anestheics lidocaine with the anesthetic and prilocaine in a ratio of 1:1 creates an eutectic mixture (“Eutectic Mixture of Local Anesthetic”, EMLA) which is liquid at skin temperature and has good penetration into the skin.<ref>{{REFweb

Lander et al. (1997) did a comparison study of EMLA® cream topical anesthetic.<ref>{{REFweb |url=https://medical-dictionary.thefreedictionary.com/Emla+cream |title=Emla cream |last=Anonymous |publisher=The Free Dictionary by Farley |date=2005 |accessdate=2023-11-24}}</ref> EMLA® was the least-effective of the three analgesia methods studied.<ref name="lander1997">{{LanderJ etal 1997}}</ref> Before the specification of the approval in 2013, EMLA EMLA® ointment was often used in the so-called ''off-label use''<ref>{{REFweb

}}</ref> in neonatal circumcision. In addition, EMLA EMLA® ointment does not require a prescription and can therefore be purchased over the counter. As a result, a medical risk assessment for off-label use is not guaranteed. Even less can it be assumed that the partly non-physician group of people who use EMLA® ointment for newborn circumcision recognizes the symptoms of toxic drug levels in the newborn, let alone masters them.<ref name="Wakankar 2014-02-18">{{REFweb

In June 2013, the use of EMLA® ointment in neonatal [[circumcision ]] was deemed “ethically unacceptable” by the CMDh group at the EMA.<ref>{{REFweb

Various The conclusion of various studies come to show that the conclusion that EMLA-circumcisions effectiveness of young children are EMLA® is not suitable sufficient to sufficiently exclude the [[pain]] of non-therapeutic infant [[circumcision]].<ref name="lander1997" /> <ref>{{REFjournal

}}</ref><ref>{{REFjournal

In July 2013, the German Federal Institute for Drugs and Medical Devices (BfArM) revoked the ''indication'' of the anesthetic ointment EMLA EMLA® for [[circumcision ]] of newborns.<ref>{{REFweb

}}</ref> EMLA EMLA® has never had an ''approval'' for newborn [[circumcision]], as the BfArM confirmed on March 7, 2013 to a medical member of [[Beschneidungsforum.de]]. The never-existing approval is evident from the technical information and instructions for use for EMLA EMLA® and the drug law. The indications are under 4.1 of a technical and user information. Newborn circumcision was never performed there in Germany.<ref name="Wakankar 2014-02-19">{{REFweb

The German manufacturer of the EMLA EMLA® ointment now confirms (at the latest since 2018) in the leaflet:

'''Do not use EMLA EMLA® on the following skin areas:'''

The [[German Circumcision Act]] of 2012 implemented a so-called [[Mohel]] clause in paragraph 2, which states that up to the end of the sixth month of life, a boy can also be [[circumcised ]] by a non-medical practitioner, as long as he is "trained" for this form of genital mutilation. The [[Circumcision Debate]] of that time impressively proves that Jewish [[Mohel]]s and other Jewish advocates of [[circumcision]] for boys repeatedly referred to the EMLA EMLA® ointment as an adequate pain treatment.