title: Loss of anatomical landmarks with eutectic mixture of local anesthetic cream for neonatal male circumcision.
abstract: We report two cases of newborns who developed marked local edema after application of a eutectic mixture of local anesthetic (EMLA) topical anesthetic cream for neonatal male circumcision (NMC). Although local edema and erythema are known potential side effects of EMLA cream, a common anesthetic used for NMC, the loss of landmarks precluding safe NMC has not previously been reported, and is described here. Although we cannot recommend an alternate local anesthetic for neonates with this reaction to EMLA, based on a review of the published data we think that serious systemic adverse events related to EMLA are extremely rare.
authors.affiliation: Division of Infectious Diseases, Brigham and Women's Hospital, Boston, USA. rplank@partners.org
authors.forename: Rebeca M
authors.initials: RM
authors.lastname: Plank
authors.forename: David W
authors.initials: DW
authors.lastname: Kubiak
authors.forename: Rasak Bamidele
authors.initials: RB
authors.lastname: Abdullahi
authors.forename: Nnamdi
authors.initials: N
authors.lastname: Ndubuka
authors.forename: Maggie M
authors.initials: MM
authors.lastname: Nkgau
authors.forename: Fredrick
authors.initials: F
authors.lastname: Dapaah-Siakwan
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Powis
authors.forename: Shahin
authors.initials: S
authors.lastname: Lockman
mesh_terms: D000287:Administration, Topical; D059925:Anatomic Landmarks / Q000473:pathology*; D002944:Circumcision, Male / Q000379:methods*; D004487:Edema / Q000139:chemically induced* / Q000473:pathology; D052816:Foreskin / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D011318:Prilocaine / Q000008:administration & dosage / Q000009:adverse effects*; D063465:Skin Cream / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine