Turkish Journal of Pediatric Surgery

Mustafa Akman

İstanbul Medipol Üniversitesi, İstanbul, Türkiye

Keywords: EMLA cream, circumcision, local anesthesia, pediatric surgeon


Objective: Studies on neonatal pain are ongoing. Complications regarding the physiology of neonates, low GFR rate, limited drug use, methemoglobinemia, which is not found in other age groups lead to the search for safe drugs for painless operation. The idea that neonates do not feel pain has come to avoid pain caused by injection today. Therefore, EMLA® Cream, which is known to be effective with topical application, has become popular. Our study aims to reveal how the cream, which its analgesic effect is still doubted, is used by pediatric surgeons and to determine its common usage principles.

Methods: Many surgeons from every continent and many different countries were contacted via e-mail. The questionnaire, with few questions and limited choices, was completed by the physicians. The participants were kept anonymous and interaction among them was prevented. Upon 10% returns from the e-mails sent, the questionnaire was terminated and subjected to basic evaluation.

Results: The survey was completed in 107 women and 238 men, 345 participants. The results showed that 82 participants circumcised only using the cream and 91 surgeons who did not use the cream could use it in the future. The results also showed that 74.78% of the participants who avoided the cream had doubts about its pain prevention impact. The rate of avoidance of cream due to fatal side effects was 3.76%. According to the accommodation area of the participants, 36%-67% relied on the cream and performed neonatal circumcision.

Conclusion: Pediatric surgeons consider that the idea of neonates to feel pain is important and despite its positive effect on pain, the cream is not used by all pediatric surgeons around the world. Despite its local anesthetic effect occurring without injection, side effects or usage difficulties, the cream will still be popular.

Cite as: Akman M. What is world pediatric surgeons’ opinion on EMLA® cream induced local anaesthesia in circumcision?. Çoc. Cer. Derg. 2021;35(3):137-42.