Pain: Difference between revisions
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* Rawlings, Miller & Engel (1980) showed that as the pain of circumcision increased, oxygenation of the skin decreased.<ref name="rawlings1980">{{REFjournal | * Rawlings, Miller & Engel (1980) showed that as the pain of circumcision increased, oxygenation of the [[skin]] decreased.<ref name="rawlings1980">{{REFjournal | ||
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Three methods were proposed: | Three methods were proposed: | ||
* Application of EMLA Cream topical anesthetic. EMLA is a eutectic mixture of lidocaine 2.5% and prilocaine 2.5%. EMLA Cream (lidocaine 2.5% and prilocaine 2.5%), applied to intact skin under occlusive dressing, provides dermal analgesia by the release of lidocaine and prilocaine from the cream into the epidermal and dermal layers of the skin and by the accumulation of lidocaine and prilocaine in the vicinity of dermal pain receptors and nerve endings.<ref>{{REFweb | * Application of EMLA Cream topical anesthetic. EMLA is a eutectic mixture of lidocaine 2.5% and prilocaine 2.5%. EMLA Cream (lidocaine 2.5% and prilocaine 2.5%), applied to intact [[skin]] under occlusive dressing, provides dermal analgesia by the release of lidocaine and prilocaine from the cream into the epidermal and dermal layers of the [[skin]] and by the accumulation of lidocaine and prilocaine in the vicinity of dermal pain receptors and nerve endings.<ref>{{REFweb | ||
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* There is, of course, post-surgical pain, which may be relieved by a potent oral analgesic. One should have a two-week supply of analgesic medicine. | * There is, of course, post-surgical pain, which may be relieved by a potent oral analgesic. One should have a two-week supply of analgesic medicine. | ||
* The recovery period for adolescent and adult circumcision is usually placed at six weeks. During that period of time, many patients experience pain when they they have involuntary nocturnal erections and the erection tightens the residual skin and pulls at the incision and suture.<ref>{{REFjournal | * The recovery period for adolescent and adult circumcision is usually placed at six weeks. During that period of time, many patients experience pain when they they have involuntary nocturnal erections and the erection tightens the residual [[skin]] and pulls at the incision and suture.<ref>{{REFjournal | ||
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* That is not the only source of pain. [[Circumcision]] amputates the protective [[foreskin]]. In cases of [[phimosis]], the [[glans penis]] may never have been exposed before, so there frequently is severe pain when the glans penis touches anything. Many men complain that they are unable to wear trousers for an extended period of time. Only time and [[keratinization]] can ease this pain. | * That is not the only source of pain. [[Circumcision]] amputates the protective [[foreskin]]. In cases of [[phimosis]], the [[glans penis]] may never have been exposed before, so there frequently is severe pain when the glans penis touches anything. Many men complain that they are unable to wear trousers for an extended period of time. Only time and [[keratinization]] can ease this pain. | ||
* Circumcision is inexact surgery. Surgeons have to guess at how much skin to amputate, so they frequently get it wrong. If sufficient skin is not available to permit penis expansion during times of erection, then taut, painful erections are the result. This complication may be treated by [[tissue expansion]]. The tension may also cause [[wound dehiscence]], which would cause additional pain. | * Circumcision is inexact surgery. Surgeons have to guess at how much [[skin]] to amputate, so they frequently get it wrong. If sufficient [[skin]] is not available to permit penis expansion during times of erection, then taut, painful erections are the result. This complication may be treated by [[tissue expansion]]. The tension may also cause [[wound dehiscence]], which would cause additional pain. | ||
* Neuromas may form at the [[circumcision scar]]. Cold & Taylor (1999) reported that they are "notorious for generating pain.".<ref name="cold-taylor1999">{{ColdCJ TaylorJR 1999}}</ref> | * Neuromas may form at the [[circumcision scar]]. Cold & Taylor (1999) reported that they are "notorious for generating pain.".<ref name="cold-taylor1999">{{ColdCJ TaylorJR 1999}}</ref> | ||