Does circumcision require anesthesia injection, or can topical anesthesia be used, or is general anesthesia necessary? I want to know the doctor’s technique. The doctor can circumcise children aged 7-8 years comfortably. If the patient wants to upgrade size along with circumcision, they can lie down and relax. Sometimes, if they want to do a full, long, and extensive course at the same time, it’s still fine. I want to know how Dr. Beer circumcises without causing pain.
Circumcision must be understood first that nowadays, if we talk about traditional techniques, the method involves nerve blocking. The penis has a nerve called the Dorsal nerve, which is the sensory nerve.
This Dorsal nerve runs along the midline of the back of the penis and is responsible for all sensation. A skilled doctor knows the exact location of this nerve, allowing for precise nerve block or anesthesia injection. The sensation block of the penis can be considered 100 percent effective.
Therefore, an expert doctor knows how to block the nerve completely so the patient does not feel pain. Regarding the procedure, some ask if general anesthesia is needed or if topical anesthesia can be used. You must understand that if circumcision involves removing all the foreskin, topical anesthesia is not effective. In such cases, the doctor does not recommend it and it cannot be done. Also, the penis is a highly sensitive area.
Thus, topical anesthesia for circumcision is not possible. The main nerve to block is the dorsal nerve, which covers about 80% of the penile surface sensation. There are also smaller nerves on the underside covering about 20%. A doctor who knows this technique will need to inject anesthesia about twice to block these nerves. However, Dr. Beer’s technique involves only one injection, causing just a tiny ant-like sting.
To inject anesthesia painlessly, first, the injection must precisely target the nerve location. Second, anesthesia injection is not just done quickly. If the person injecting is heavy-handed, it will hurt. The doctor is very meticulous, using the smallest needle and injecting the anesthesia very slowly. When anesthesia is injected slowly, the patient feels no pain.
Another important point is that anesthesia does not work instantly. It takes about 15-20 minutes to take full effect. I usually tell patients to wait until the anesthesia is fully effective. Also, the anesthesia contains agents that help stop bleeding, so it numbs and controls bleeding simultaneously. The technique is to inject anesthesia and wait for full effect, not to inject continuously while the patient is already on the table. Dr. Beer does not do it that way.
Will it hurt after the procedure? If the nerve block is 100% effective before the procedure and there is no pain stimulation during the procedure, medical research shows that pain stimulation is less than normal, resulting in less pain after surgery.
Therefore, if the doctor is meticulous in injecting anesthesia before the procedure, there will be no pain afterward. Nowadays, there are wound closure techniques that prevent the wound from contacting the environment, making wound care easier and reducing pain during and after the procedure. Even after a week, there is no pain. It really exists.
When is general anesthesia necessary for circumcision? General anesthesia is mainly used for children, mostly under 5 years old, because young children cannot cooperate. Traditional techniques take about 30-40 minutes, so circumcision cannot be done on children without general anesthesia.
For circumcision, I use anesthesia injection in almost 99% of cases, except when general anesthesia is needed, usually when the patient requests additional procedures related to the penis or other concurrent conditions.
So, unless there is such a case, Dr. Beer almost always uses anesthesia injection. If the patient insists on no pain at all, general anesthesia is used. But I must say that general anesthesia requires intravenous fluids to put you to sleep. It is not like in movies where anesthesia is just applied and you instantly fall asleep.
In practice, this cannot be done otherwise. So, the anesthesiologist will insert an IV needle to give fluids to make you sleep. I can say that the needle used for that is even more painful than the needle Dr. Beer uses for anesthesia injection because my needle is smaller. So, my advice is that nowadays, there is no need to worry. Circumcision is painless, Dr. Beer guarantees it.
