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Anesthesia for Circumcision

by Marjorie Greenfield, M.D.
reviewed and revised by Marjorie Greenfield, M.D.
In the past, anesthetic was not used for circumcision. However, experts now agree that infants do feel pain. In studies that compared local anesthesia to no anesthetic, for instance, the babies were found to cry less, maintain a more normal heart rate during the procedure, and were less irritable afterwards when local anesthesia was used.

Many practitioners now use one of the three available local anesthetic techniques.

  • Topical anesthetic (EMLA) cream can be put on about an hour before the procedure to numb the skin. This is the least invasive method of anesthesia, but isn't quite as effective as the other two methods.


  • Ring block (local anesthesia) is done by injecting local anesthetic (like the dentist uses) around the bottom of the foreskin near where the incision will be made.


  • Penile block (nerve block) is done by injecting local anesthetic at the base of the penis, where the nerves for pain are located.
Other methods of calming a newborn during circumcision include giving a pacifier, stroking him, and talking quietly to him. In our nursery, a medical assistant is with the baby for that purpose during circumcision, since parents aren't usually allowed to be there. Infant acetaminophen (Tylenol) can be given before or after circumcision, in case there is some pain after the anesthetic wears off.

You may wonder why they don't put the baby to sleep for circumcision. General anesthesia has a lot more risk than local, and isn't necessary for such a short procedure. The above local anesthetics and other techniques for calming the baby seem to work well, and strike a balance between risk and benefit.

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Created March 23, 2003
Reviewed and revised August 05, 2004
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