By Dr Sara Hunt
Teaching today was against a background of a child screaming non-stop as it had a circumcision with just “ local infiltration”as anaesthetic i.e. local anaesthetic injected around the site of operation.
This is very ineffective as it doesn’t block the specific nerves and the child will have experienced severe pain. It would never be acceptable in the
This was a very difficult situation for us. We felt we had to question the method, but this would be confronting something that is obviously a regular part of the local practice. Presumably some of their own sons had been circumcised like this and, by directly suggesting an alternative, we might be treading on cultural divisions as well as directly criticising the status quo.
So a few days later we introduced a teaching session on how to perform a penile block anaesthetic, which is safe and effective. We hadn't planned to teach this, but it seemed to be the best way to change practice without directly questioning established method.
It was very well received and we hope they will try this in future.
An example of how you have to adapt the plannned teaching to what you actually find you need when you get there.