Changes

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">{{REFjournal |last=Lander |init=J |first=Janice |author-link= |last2=Brady-Frerer |init2=B |first2=Barbara |author2-link= |last3=Metcalfe |init3=JB |first3=James B. |author3-link= |last4=Nazerali |init4=S |first4=Shermin |author4-link= |last5=Muttit |init5=S |first5=Sarah |author5-link= |etal=no |title= Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision |journal=JAMA |location= |date=1997-12-24 |volume=278 |issue=24 |pages=2157-64 |url=http://www.cirp.org/library/pain/lander/ |archived= |quote= |pubmedID=9417009 |pubmedCID= |DOI= |accessdate=2023-12-01}}</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