Topical anesthesia during circumcision in newborn infants

Objective. —To determine the efficacy of topical anesthetic cream, eutectic mixture of local anesthetics (EMLA), in alleviating pain from neonatal circumcision. Design. —Randomized, controlled trial. Setting. —Normal newborn nursery in a university teaching hospital. Patients. —Twenty-seven newborn, full-term male neonates, aged 1 to 3 days. Outcome Measures. —Heart rate, transcutaneous oxygen saturation, facial activity, and crying. Results. —Compared with baseline, all newborns experienced pain as evidenced by increased heart rate of an average of 40 beats per minute (F 8, 25=14.12;PPPPPPConclusions. —Circumcision procedure produces pain responses that EMLA diminishes. Thus, EMLA may be a useful agent for pain management in neonatal circumcision. (JAMA. 1993;270:850-853)