Loss of anatomical landmarks with eutectic mixture of local anesthetic cream for neonatal male circumcision

J Pediatr Urol. 2013 Feb;9(1):e86-90. doi: 10.1016/j.jpurol.2012.09.013. Epub 2012 Oct 24.

Abstract

We report two cases of newborns who developed marked local edema after application of a eutectic mixture of local anesthetic (EMLA) topical anesthetic cream for neonatal male circumcision (NMC). Although local edema and erythema are known potential side effects of EMLA cream, a common anesthetic used for NMC, the loss of landmarks precluding safe NMC has not previously been reported, and is described here. Although we cannot recommend an alternate local anesthetic for neonates with this reaction to EMLA, based on a review of the published data we think that serious systemic adverse events related to EMLA are extremely rare.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Administration, Topical
  • Anatomic Landmarks / pathology*
  • Circumcision, Male / methods*
  • Edema / chemically induced*
  • Edema / pathology
  • Foreskin / drug effects*
  • Foreskin / pathology
  • Humans
  • Infant, Newborn
  • Lidocaine / administration & dosage
  • Lidocaine / adverse effects*
  • Lidocaine, Prilocaine Drug Combination
  • Male
  • Prilocaine / administration & dosage
  • Prilocaine / adverse effects*
  • Skin Cream / administration & dosage
  • Skin Cream / adverse effects

Substances

  • Lidocaine, Prilocaine Drug Combination
  • Prilocaine
  • Lidocaine