Anxiety and cortisol levels during circumcision

Aim: In this study, we aimed to investigate whether circumcision is a stressor ambulatory surgical intervention for children and demonstrate the relationship between pre- and post-operative anxiety levels, blood cortisol levels (BCL), and salivary cortisol levels (SCL) in these children. Material and Method: Boys aged between 5 and 17 years, with a plan of circumcision, were prospectively included. Their preoperative anxiety levels, salivary cortisol levels (SCL), and blood total cortisol levels (BCL) were measured. After the operation, the same parameters were measured and preoperative values were compared with postoperative values. Also, the correlation between anxiety scores, SCL, and BCL was assessed. The Yale Preoperative Anxiety Scale was used to calculate the anxiety scores. Results: The mean age of 81 patients was 6.62 +/- 1.40 years. The preoperative anxiety scores, SCL, and BCL were significantly lower than post-operative values (p<0.001 for each). The preoperative SCL were positively correlated with BCL and anxiety scores. Postoperative SCL were positively correlated with BCL and anxiety scores. Discussion: Circumcision is a cause of increment in anxiety, serum, and salivary cortisol levels in children. Salivary cortisol levels were correlated with simultaneously drawn serum cortisol levels. The preoperative and postoperative anxiety scores were correlated with BCL and SCL in children with circumcision operation.