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Edgar J. Schoen, MD
Kaiser Permanente Medical Center Oakland, Calif University of California, San Francisco, School of Medicine

Anne A. Fischell, MD
Kaiser Permanente Medical Center Oakland, Calif

JAMA. 1989;261(5):701-702.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Stang et al,¹ in the March 11 issue of JAMA, found that dorsal penile nerve block (DPNB) for neonatal circumcision reduced behavioral distress and cortisol response in 20 infants and recommended that the procedure be generally applied.

However, we should be cautious before recommending local anesthesia for all newborn circumcisions, because there has been only limited experience with DPNB. Newborn circumcision without anesthesia, when properly performed, is a quick and safe procedure. Since the early 1940s, 50 to 60 million US infants have been circumcised (1.2 to 1.5 million infants per year) with very few complications. Although no doubt exists that newborns feel pain, behavioral changes are transitory and disappear within 24 hours² with no evidence of long-term psychological consequences. Dorsal penile nerve block prolongs circumcision and adds a new procedure with some known risks, such as hematoma and local necrosis.³ Of special concern . . . [Full Text PDF of this Article]

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