Pain Relief for Neonatal Circumcision: A Follow-up of Residency Training Practices

Yawman, Daniel; Howard, Cynthia R.; Auinger, Peggy; Garfunkel, Lynn C.; Allan, Marjorie; Weitzman, Michael

doi:10.1016/j.ambp.2006.04.008

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Volume 6, Issue 4 , Pages 210-214, 1 July 2006

Pain Relief for Neonatal Circumcision: A Follow-up of Residency Training Practices

Daniel Yawman, MD, MPH
- Department of Pediatrics, University of Rochester, School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Rochester, NY
- Department of Pediatrics, Rochester General Hospital, Rochester, NY
- Address correspondence to Daniel Yawman, MD, MPH, Rochester General Hospital, Department of Pediatrics, Suite 300 MOB, 1425 Portland Avenue, Rochester, NY 14621-3095.
Cynthia R. Howard, MD, MPH
- Department of Pediatrics, University of Rochester, School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Rochester, NY
- Department of Pediatrics, Rochester General Hospital, Rochester, NY
Peggy Auinger, MS
- Department of Pediatrics, University of Rochester, School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Rochester, NY
- Department of Pediatrics, Rochester General Hospital, Rochester, NY
Lynn C. Garfunkel, MD
- Department of Pediatrics, University of Rochester, School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Rochester, NY
- Department of Pediatrics, Rochester General Hospital, Rochester, NY
Marjorie Allan, BS
- Department of Pediatrics, University of Rochester, School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Rochester, NY
Michael Weitzman, MD
- Department of Pediatrics, University of Rochester, School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Rochester, NY
- AAP Center for Child Health Research, Rochester, NY

Received 7 September 2005; accepted 13 April 2006.

Objective

To assess current training practices regarding the provision of effective analgesia for routine newborn circumcision.

Methods

All family practice (FP), obstetric and gynecologic (OB/GYN), and pediatric (PED) residency program directors in the United States received a mailed survey in 2003 (N = 940).

Results

Survey responses were received from 86% (811/940) of the programs (FP 88%, OB/GYN 82%, and PED 87%). Eighty-two percent (669/811) of all programs surveyed taught circumcision (FP 95%, OB/GYN 89%, and PED 49%). Of programs that taught circumcision, 97% (648/669) taught the administration of an anesthetic, either locally or topically. This proportion is significantly higher than that reported in 1998 (71%, 374/527; P < .001). However, of these same programs that taught circumcision, the anesthetic techniques were used frequently or always in only 84%.

Conclusions

The percentage of training programs that teach effective analgesia for neonatal circumcision increased dramatically since the time of the previous data collection. Despite this improvement in teaching practices, some training programs may not consistently use effective analgesia for neonatal circumcision.

Key words: circumcision , newborn , pain , residency