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Circumcision, Neonates, Pain sensation

Journal of the Korean Pediatric Society 1995;38(10):1324-1328.
Published online October 15, 1995.
Circumcision, Neonates, Pain sensation
In Rok Do, Jeong Ho Lee, Yong Sub Kim, Jong Dae Jo
Department of Pediatrics, Maryknoll Hospital, Busan, Korea
신생아 포경 수술시 통각 감지에 대한 고찰
도인록, 이정호, 김용섭, 조종대
부산메리놀병원 소아과
Abstract
Purpose
: Routine neonatal circumcision has widely performed without anesthesia under the assumption that the penis of neonates does not yet have functioning pain sensory nerve endings at this early stage of development, and has decreased the incidence of neonatal urinary tract infection. This study was performed to evaluate whether neonates recognize pain during opertion of circumcision without anesthasia.
Methods
: We evaluated the physiologic responses of 30 infants during operation of circumcision without anesthasia throught checking the crying time by sound recording & heart rate by pulse oxymetry.
Results
: 1) Mean gestational age at circumcision and mean birth weight were 39.8¡¾1.2 weeks and 3182.7¡¾274.8gm respectively. There was no specific findings at birth. 2) Mean crying time was 5.4¡¾0.5 minutes, and it was 74.5% of total operation time. Therfore that was a significant change. 3) Heart rates measured to estimate physiologic change were increased by 18.7¡¾5.2% of basal heart rte at stage 2 and by 32.0¡¾5.6% of basal heart rate at stage 3 respectively.
Conclusion
: We conclude that neonatal circumcision for prevention of many disease related to phimosis are useful but burdens neonates with a lot of pain and physiologic stress. Therefore we might consider the gestational age of neonates in case of circumcision without anesthesia and employing local anesthesia is needed for alleviate such pain or physiologic stress. And careful selection of neonates for circumcision should be considered.
Key Words: Circumcision, Neonates, Pain sensation


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