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Title: Infants Feel and Remember Circumcision Pain - Study
URL: http://www.pslgroup.com/dg/1F21E.htm
Doctor's Guide
February 28, 1997


TORONTO, Feb. 28, 1997 - Male infants feel pain during circumcision and they remember that pain six months later when they receive their routine vaccination, according to a study led by Hospital for Sick Children (HSC) researchers.

The results of this study, led by Dr. Gideon Koren, head of Clinical Pharmacology & Toxicology at HSC and a Professor of Paediatrics, Pharmacology, and Medicine at the University of Toronto, are reported in the March 1 issue of the British medical journal Lancet.

Earlier research led by Dr. Koren had indicated that male infants demonstrate a greater pain response to vaccination than female infants. The current study sought to determine whether there was a difference between circumcised and uncircumcised male infants in their pain response to vaccination, and whether pretreatment of circumcision pain with a topical anaesthetic affected the pain response to vaccination.

The study involved 87 male infants in three groups: 32 uncircumcised infants; 29 infants receiving a topical anaesthetic prior to circumcision; and 26 who were circumcised without pain relief. The infants were recruited to the study through Women's College Hospital. Between ages four and six months, the infants received routine diptheria-pertussis-tetanus (DPT) vaccinations from their primary care physician and their pain response to the vaccination was measured.

"What we discovered was that the infants who were uncircumcised demonstrated the least pain during vaccination," Dr. Koren explains. "The infants who were circumcised showed substantially more pain."

Pain response was measured by monitoring facial expression, duration of crying, blood pressure, and heart rate. In addition, parents and the primary care physician completed a questionnaire regarding their perception of the severity of pain the infant was experiencing.

"This study demonstrates two important findings," says Dr. Koren. "It shows that infants do in fact feel pain, and that their pain is not short-lived, as previously thought. Consequently, adequate pain relief should be routinely used during circumcision and any other medical and surgical procedures where pain is possible."

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