Circumcision study halted due to trauma

A newborn winces in pain after a circumcision

December 23, 1997

Web posted at: 11:46 p.m. EST (0446 GMT)

ATLANTA (CNN) -- A new study found circumcision so traumatic that doctors ended the study early rather than subject any more babies to the operation without anesthesia.

The researchers discovered that for those circumcised without anesthesia there was not only severe pain, but also an increased risk of choking and difficulty breathing.

The necessity of circumcision is the subject of increasing debate , but the traditional reasons for the operations have always been prevention.

Dr. Arthur Gumer of Northside Hospital in Atlanta says circumcision has been thought to provide "protection against infectious diseases later in life which would include either sexually transmitted diseases or urinary tract infections."

Up to 96 percent of the babies in the United States and Canada receive no anesthesia when they are circumcised, according to a report from the University of Alberta in Edmonton.

One of the reasons anesthesia is not used, the study found, is the belief that infants feel little or no pain from the procedure. It has also been argued that injecting anesthesia can be as painful as circumcision itself, and that infants don't remember the procedure, anyway.

Study measured heart rate, crying pattern

Preparation for a circumcision

But there are those who find that reasoning difficult to believe, and Gumer is one of them.

"To say that the baby doesn't remember it is not an adequate excuse to me," he said. "Babies experience other painful procedures and we worry about that, and we do give them anesthetics for those procedures."

But the Edmonton researchers, whose study was published in this week's Journal of the American Medical Association, studied the heart rates and crying patterns of babies during different stages of circumcision. Some babies were given an anesthetic and others were not.

Topicals woefully inadequate

Rabbi Ariel Asa has performed hundreds of circumcisions. When families request it, he says he puts an anesthetic on the skin, in an effort to reduce some of the pain. But he admits it's not very effective.

"Due to the fact that moyels (the people who do the procedure) do it very quickly and the pain that the baby experiences is minimal, I don't think that the overall benefits are gained," he says.

But the researchers found that while topical anesthetics may help initially, they are woefully inadequate during foreskin separation and incision.

They concluded that if circumcision must be performed, it should be preceded by an injected anesthetic.

In fact, they found the results so compelling that they took the unusual step of stopping the study before it was scheduled to end rather than subjecting any more babies to circumcision without anesthesia.

Medical Correspondent Dr. Steve Salvatore and Reuters contributed to this report.