Towards more humane circumcision: the use of local anaesthesia in circumcision

ABSTRACT

Circumcision is performed under five techniques for operative and postoperative pain controI. The purpose of this study was to compare between five anaesthetic techniques used during circumcision for the achievement minimal postoperative pain. In a twelve-month prospective study, 450 boys of different age were randomized into five groups. In group I, no analgesia was given, in groups II and III, IocaI infiltration was done by xylocaine or xylocaine marcaine mixture, while groups IV and V received general anaesthesia. In group V, local infiltration by xylocaine marcaine mixture was done in addition to generaI anaesthesia. The groups were compared for operating room time. The time of stay in post anaesthesia care unit [PACU] was significantly shorter in group I, II and III and children in the first group were agitated and need sedation. The percentage of children who needed analgesia in the immediate postoperative period was greater in group I and IV than in group II, III and V; also it recorded the Iowest value in the third group. Severe degree of crying was noticed frequently in group I, II and IV. In group III and IV most of the children [more than 70 %] were calm during the procedure Conclusion: Circumcision without local anaesthesia leads to considerable degree of pain with possible Iong-term effects. Xylocaine + marcaine mixture resulted in best pain relief during and after the procedure with rapid discharge. General anaesthesia alone results in severe pain after recovery. Adding sucrose pacifier during the procedure was very useful. Lastly, it is the right of every newborn boy to have painless circumcision