EMLA: Difference between revisions

'''EMLA''' ointment is a local anesthetic.

The combination of lidocaine with the anesthetic 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

Before the specification of the approval in 2013, EMLA ointment was often used in the so-called ''off-label use''<ref>{{REFweb

}}</ref> in neonatal circumcision. In addition, 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

Various studies come to the conclusion that EMLA-circumcisions of young children are not suitable to sufficiently exclude the [[pain]].<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 for circumcision of newborns.<ref>{{REFweb

}}</ref> 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 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 ointment now confirms (at the latest since 2018) in the leaflet:

'''Do not use 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 ointment as an adequate pain treatment.