What is World Pediatric Surgeons’ Opinion on EMLA® CreamInduced Local Anaesthesia in Circumcision?


Çocuk Cerrahisi Dergisi, vol.35, no.3, pp.137-142, 2021 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 35 Issue: 3
  • Publication Date: 2021
  • Doi Number: 10.5222/jtaps.2021.70845
  • Journal Name: Çocuk Cerrahisi Dergisi
  • Journal Indexes: Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.137-142
  • Istanbul Medipol University Affiliated: Yes


Objective: Studies on neonatal pain are ongoing. Complications regarding the physiology ofneonates, low GFR rate, limited drug use, methemoglobinemia, which is not found in other agegroups lead to the search for safe drugs for painless operation. The idea that neonates do not feelpain has come to avoid pain caused by injection today. Therefore, EMLA® Cream, which is knownto be effective with topical application, has become popular. Our study aims to reveal how thecream, which its analgesic effect is still doubted, is used by pediatric surgeons and to determineits common usage principles. Methods: Many surgeons from every continent and many different countries were contacted viae-mail. The questionnaire, with few questions and limited choices, was completed by thephysicians. 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 tobasic evaluation. Results: The survey was completed in 107 women and 238 men, 345 participants. The resultsshowed that 82 participants circumcised only using the cream and 91 surgeons who did not usethe cream could use it in the future. The results also showed that 74.78% of the participants whoavoided the cream had doubts about its pain prevention impact. The rate of avoidance of creamdue 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 anddespite its positive effect on pain, the cream is not used by all pediatric surgeons around theworld. Despite its local anesthetic effect occurring without injection, side effects or usagedifficulties, the cream will still be popular.