Posttraumatic stress disorder symptoms in children exposed to circumcision under general or local anesthesia

The aim of this study was to investigate the impact of general versus local anesthesia on the Posttraumatic Stress Disorder (PTSD) symptoms after circumcision. Of the 134 consecutive children (7-12 years of age) who underwent circumcision, 71 had general anesthesia (GA) and 63 had local anesthesia (LA). All participants completed the child depression inventory (CDI), State Anxiety (SA) and Trait Anxiety (TA) inventories, and Childhood Anxiety Sensitivity Index (CASI) before the operation as well as the Child Posttraumatic Stress Reaction Index (CPSRI) one month after the operation. The CDI, CASI and TA scores of the children were similar in both groups, while the SA scores of the LA group were higher than those in GA group (p<0.001). The CPSRI scores of the GA group were higher than those of the LA group (p=0.04). When the other parameters were controlled via regression analysis, only the CDI scores and being in the GA group predicted the CPSRI scores. This study suggests that children witnessing the surgical procedure of the circumcision developed no serious symptoms of PTSD. In contrast, children exposed to GA during circumcision developed more serious PTSD symptoms than children who had LA. The severity of depressive symptoms may be important in the development of PTSD symptoms after circumcision.