The controversy continues in the medical profession about the use of anesthesia when performing a circumcision. But since everyone in the medical profession has the ethical responsibility to minimize pain in all patients, a universal approach toward the use of anesthesia during circumcisions needs to be adopted. Even though most doctors believe that newborns experience minimal or no pain during and after circumcisions, scientific research explores a different theory and new ways of dealing with the pain related to the circumcision.
Newborns can show response to painful stimuli both physiologically and behaviorally.
Physiological responses include change in heart rate and transcutaneous partial oxygen pressure, along with altered levels of serum cortisol, catacholimines, growth hormones, glucagon, insulin, and aldosterone. Behavioral responses include facial grimancing, varying crying responses, and disturbances in normal behavior. Research has also shown that babies have more problems with routine immunizations when they have had circumcisions without anesthesia. There are several techniques that can be implemented for pain control before a circumcision is performed. However, EMLA cream has not been approved in the United States for use on infants under 6 months of age due to the increased risk of methemoglobinemia caused by the immature methemoglobin reductase system of a newborn.