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# Before circumcision surgery can commence, the surgeon must first forcibly separate these two highly innervated body parts in an exquisitely painful procedure by the passage of forcing a blunt probe between the two parts to destroy, rip and tear the [[synechia]] apart.<ref>{{REFjournal

}}</ref> Nervous tissue requires a large blood supply, so the foreskin is richly vascular vascularized with many blood vessels,<ref name="fleiss-hodges-vanhowe1998">{{REFjournal

Lander ''et al''. (1997) conducted a comparison of no neonatal non-therapeutic circumcision without anesthesia (current practice in 1997), 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.<ref name="lander1997">{{REFjournal

}}</ref>  With no anesthesia, the infants screamed 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).<ref name="lander1997" /> 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.<ref name="lander1997" />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.<ref name="lander1997" />