The effects of circumcision on serum cortisol and behavior

Gunnar, Megan R.; Fisch, Robert O.; Korsvik, Sherry; Donhowe, John M

doi:10.1016/0306-4530(81)90037-8

Cited by 89 publications

(49 citation statements)

References 8 publications

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“…There is substantial clinical experience and research that clearly documents the neonate's ability to experience and perceive pain. [1][2][3][4] In addition, recent data would suggest that a painful experience in the newborn has an effect on how pain is perceived later in life. 20,21 The AAP, in recognition of neonatal pain, has strongly recommended the use of pain relief for all neonatal surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple papers have detailed the capability of neonates to experience pain [1][2][3][4] and its psychological and physiologic effects.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] The American Academy of Pediatricians (AAP) has endorsed the use of anesthesia for neonatal procedures by stating that "local or systemic pharmacologic agents now available permit safe administration of anesthesia or analgesia to neonates undergoing surgical procedures . .…”

mentioning

confidence: 99%

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Circumcision Practice Patterns in the United States

Stang

Snellman

1998

Pediatrics

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ABSTRACT. Objective. To determine 1) the performing of circumcision by medical specialty, gender, and years of practice; 2) the pattern of anesthetic use for this procedure; and 3) the reasons physicians cite for not using anesthesia.Design. A total of 3066 questionnaires were received from a mailing to a representative sampling of physicians stratified by specialty and geographic location.Results. Fifty-eight percent (1768) of the questionnaires were returned and interpretable from the following specialists: pediatricians (PEDs), 73% (n ‫؍‬ 691); family practitioners (FPs), 52% (n ‫؍‬ 464); and obstetricians (OBs), 51% (n ‫؍‬ 623).Of the respondents, 956 (54%) perform at least one circumcision per month (35% of PEDs; 60% of FPs; 70% of OBs). Of the physicians performing circumcisions, 45% use anesthesia (71% of PEDs; 56% of FPs; 25% of OBs). Of physicians using anesthesia, 85% use dorsal penile nerve block.A significantly higher percentage of male physicians (57%) are performing circumcisions than are females (45%), but there was no difference in the percent using anesthesia. Recently trained PEDs and FPs were more likely to use anesthetics than were their older colleagues, but OB use of pain relief was independent of their practice longevity. Physicians in the western states were significantly more likely to use anesthesia than were other physicians from the rest of the United States.Respondents who did not use anesthesia cited "concern over adverse drug effects" (54%) followed by "procedure does not warrant anesthesia" (44%) as the most common explanations.Conclusions. A substantial number of PEDs are performing circumcisions, and they are most likely to use anesthesia (71%), followed by FPs (56%), then OBs (25%). With recent recognition of the importance of pain reduction in neonatal procedures and the lack of substantiated contraindications to newborn anesthetic use, additional education of current practitioners, residents, and parents is required to increase the use of anesthesia for circumcision. Pediatrics 1998;101(6). URL: http://www. pediatrics.org/cgi/content/full/101/6/e5; circumcision, anesthesia for neonatal circumcision.ABBREVIATIONS. AAP, American Academy of Pediatrics; DPNB, dorsal penile nerve block; EMLA, eutectic mixture of local anesthetics; OB, obstetrician; FP, family practitioner; PED, pediatrician.

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Section: Discussionmentioning

confidence: 99%

“…Multiple papers have detailed the capability of neonates to experience pain [1][2][3][4] and its psychological and physiologic effects.…”

Section: Discussionmentioning

confidence: 99%

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Circumcision Practice Patterns in the United States

Stang

Snellman

1998

Pediatrics

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“…The European Convention on Human Rights (1950) decreases [79]; his heart rate, respiratory rate, blood pressure and stress measures such as cortisol level contains similar provisions and is in the process of being incorporated into the Human Rights Bill in the UK. increase dramatically [80][81][82][83][84]. His cry takes on a surprisingly high-pitched character observed only when a baby Although the Bill currently before Parliament contains amendments by the House of Lords exempting mainexperiences excruciating pain [64,65].…”

Section: United Kingdommentioning

confidence: 99%

“…the period after surgery [81,82,88,89]. Infants who are circumcised have been observed to suck harder, faster Given the significant, lifelong harm caused by circumcision, the clear human rights violations entailed by the and more vigorously at their bottles, making them less available to their surroundings, and less able to interact procedure, and the absence of genuine medical benefit, circumcision cannot be justified by appeal to the rights of with their mother [90,91].…”

Section: United Kingdommentioning

confidence: 99%