The Pediatric Forum |

Pain Indication in Circumcision

George Hill, MD
Arch Pediatr Adolesc Med. 2000;154(12):1275. doi:.
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Dr Taddio's previous financial relationship with AstraZeneca LP (Westborough, Mass), the manufacturer of EMLA (eutectic mixture of local anesthetics) cream topical anesthetic,1 was not mentioned in the article by Taddio et al2 in the June 2000 issue of the ARCHIVES. In fact, many issues were left untouched in the end.

The failure to provide a noncircumcised control group is one of several methodological flaws in the study.3 Taddio et al2 also do not provide a reliable indication of reduction of adrenocortical activity. Gunnar et al4 have documented that reduction of crying by sucking is not a reliable indicator of stress and trauma; sucking reduces crying but does not reduce serum cortisol levels. Lander et al5 have documented that ring block and dorsal penile nerve block are both more effective than EMLA cream. Taddio et al2 have failed to demonstrate that their proposed method is more effective than these options.

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