Introduction
Circumcision is commonly performed in male babies. There are many techniques for circumcision. Anesthesia in circumcision is essential as it is an excruciating (painful) procedure. This topic presents the requirements, risks, and procedures of circumcision. Anesthesia techniques required in these procedures are also mentioned, along with the minimal invasive anesthesia technique in circumcision.
What Is Circumcision?
Circumcision is the surgery to remove the foreskin from the baby's penis. It is the procedure done on a newborn male child within a short period. Circumcision must be done within one week of the child's birth. Although younger male children and adults can also get the procedure, it is uncommon.
All newborn baby boys do not require circumcision. Some families choose it as a religious practice for their baby boys. Some baby boys need it due to problems while passing urine or urological issues. Some adults or young males population also go for the procedure. It can be performed by a urologist (doctor specialist in urinary disorders), a pediatrician (child specialist doctor), or a surgeon, sometimes along with an anesthesiologist (the doctor who performs anesthesia).
Why Is Circumcision Performed?
Circumcision is sometimes performed as a religious or cultural practice in some families or as a preventive measure in healthcare. Circumcision has many benefits, like:
- Reduced risk of urinary tract infections.
- Prevention from sexually transmitted disease.
- Protection against penile cancers (penis cancer).
- Prevention of balanitis (swollen foreskin and head of the penis).
- Prevention from phimosis (tightening the foreskin of the penis) and paraphimosis.
What Are the Risks of Circumcision?
Risks of circumcision are:
- Pain after the procedure needs more attention to overcome.
- Bleeding can occur after the procedure, but it can be at a low rate.
- Infection can occur and can be managed.
- Scar formation.
- In some cases, more or less skin than required foreskin will be removed.
How Is Circumcision Performed?
The procedure is done as follows:
- Before the procedure, the baby or infant is given a pain relief medicine like Acetaminophen.
- The baby is made to lie on the back.
- The arms and legs of the child are stretched and restrained from moving.
- The penis of the baby is cleaned with an antiseptic.
- Local anesthesia injection, regional anesthesia, or general anesthesia is used to anesthetize the area, and the baby stops feeling pain over the penis and surrounding areas.
- The foreskin of the baby's penis is separated from the penis.
- The foreskin is removed by scalpel usage.
- After completing the procedure, the penis will be dressed.
- After the surgery, post-surgery care is essential. Doctors recommend painkillers to control pain.
What Are the Anesthetic Techniques Used in Circumcision?
Circumcision is performed under all types of local, regional, and general anesthesia. It is the choice of doctor and patient needs that depicts the anesthesia used in the surgery. Anesthesia use is:
- Local Anesthesia - Local anesthesia is used as a minimally invasive anesthesia technique. A cream or gel or injection of a low dose can cause the area on the penis to be anesthetized, and the baby will not feel any pain during the circumcision.
- Regional Anesthesia - Spinal anesthesia is used to perform circumcision by regional techniques.
- General Anesthesia - Many doctors use general anesthesia more than other techniques. General anesthesia develops a painless and no-memory formation of surgical procedures in patients.
Which Anesthesia Is the Minimal Invasive Anesthesia in Circumcision?
Minimal invasive anesthesia means a minimum usage of anesthesia during surgery, causing minimum effects on the patient's body. Altogether, it is a technique that causes minor bodily effects due to anesthesia usage. In addition, it involves only the areas requiring surgical procedures.
The anesthesia used as minimally invasive for circumcision surgery is local anesthesia. A cream or gel formed as a Lidocaine and Prilocaine combination is used to inhibit the pain effects before the surgery starts. And further blocking of the dorsal penile nerve (nerves of the penis) by injecting local anesthesia is done. The injection causes the penis and its surrounding area to get numb.
How Is Local Anesthesia Minimally Invasive?
Local anesthesia is more advantageous than regional and general anesthesia as it causes less body involvement during the circumcision procedure. Advantages are:
- Local anesthesia involves less body area than regional and general anesthesia. Regional anesthesia for circumcision uses spinal anesthesia to numb the area below the lower abdomen. In comparison, general anesthesia makes the patient's whole body go to sleep and performs surgery. And local anesthesia uses only the penile nerve (nerve of the penis) to block and numb during the surgery.
- The body gets less affected by surgical procedures as the drugs spread into the whole body and affect all organs.
- The patient's body parameters like oxygen levels, blood pressure, and temperature are not required to monitor during the surgery.
- Recovery of the patient's body after the anesthesia drop is also better than general and regional.
- Side effects of local anesthesia are less than general and regional. Side effects like nausea and vomiting are probably present in general anesthesia and are absent in local anesthesia.
Is It Safe to Go For Circumcision With Local Anesthesia?
The circumcision procedure is an excruciating surgical procedure, so its anesthesia also plays an important role in controlling pain. Doctors use the general anesthesia technique. General anesthesia causes the baby patient to have sleep and memory loss from the surgery operated on him. It also relaxes his body to perform the surgery comfortably. But the usage of local anesthesia has caused less damage to the baby's body. It is because it affects only the penile nerve and the surrounding areas, describing it wholly as minimally invasive anesthesia. In addition, local anesthesia is safe for circumcision. However, it requires a better holder to hold the baby tight while performing surgery with local anesthesia.
Conclusion
Circumcision is a very painful procedure performed on newly born baby boys. The anesthesia used can be local, general, or regional; all are used in circumcision. But minimally invasive anesthesia technique in pediatric (child) circumcision is local anesthesia. The use of local anesthesia has provided better results than general and regional anesthesia.
