title: Anesthesia for ritual circumcision in neonates.
abstract: OBJECTIVE
  To ascertain whether there is medical and religious agreement that neonates being circumcised should have anesthesia.
  
  
  OBJECTIVE
  To enquire of pediatric and anesthetic surgical bodies and religious authorities, the need for and any objections to anesthesia.
  
  
  BACKGROUND
  Many neonatal circumcisions are still carried out without anesthesia worldwide. Muslims are recommended to be circumcised but it is not a religious requirement. It can be carried out at any time, by a surgeon and anesthetist. Jewish law requires circumcision (Bris) on the eighth day, by a Jewish circumciser (a mohel) and is usually, but not essentially, in the home.
  
  
  RESULTS
  All the medical authorities agree that anesthesia should be administered. Religious authorities cannot find any reasons to avoid anesthesia. The 'any day' request for anesthesia is difficult to meet with a shortage of pediatric anesthetists. Local anesthesia is suitable, but requires skills.
  
  
  CONCLUSIONS
  (i) That anesthesia should be provided for neonatal circumcision. (ii) That there will be difficulties in providing a professional service. (iii) That EMLA cream is the most practical, even if only partly effective. (iv) A website demonstrating application to parents would encourage usage.
authors.affiliation: University of Wales, Cardiff, Wales, UK. rosen@mrosen.plus.com
authors.forename: Michael
authors.initials: M
authors.lastname: Rosen
mesh_terms: D000758:Anesthesia / Q000379:methods*; D000779:Anesthetics, Local; D002562:Ceremonial Behavior; D002944:Circumcision, Male / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D007514:Islam; D007585:Jews; D007599:Judaism; D008012:Lidocaine; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D011318:Prilocaine
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine