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[[File:PureShock.jpg|thumb|Baby in shock after circumcision]]
'''Shock''' is one of the possible consequences of [[circumcision]], especially in newborns and infants at an age when effective [[pain]] suppression with general anesthesia is not possible.<ref name="agoglu2022">{{REFjournal |last=Aydoğlu |first= |init=B |author-link= |last2=Aydoğlu |first2= |init2=M |author2-link= |last3=Okur |first3= |init3=MH |author3-link= |etal=no |title=Social and psychological effects of circumcision: A narrative review |trans-title= |language= |journal=Journal of Applied Nursing and Health |location= |date=2022-12 |volume=4 |issue=2 |pages=264-71 |url=https://janh.candle.or.id/index.php/janh/article/view/110/138 |archived= |quote= ||DOI=10.55018/janh.v4i2.110 |format=PDF |accessdate=2023-05-03}}</ref>
{{WikipediaQuote|URL=https://en.wikipedia.org/wiki/Shock_(circulatory)}}
Shock is divided into four main types based on the underlying cause: low volume, cardiogenic, obstructive, and distributive shock. Low volume shock, also known as hypovolemic shock, may be from [[bleeding]], diarrhea, or vomiting.[1] Cardiogenic shock may be due to a heart attack or cardiac contusion. Obstructive shock may be due to cardiac tamponade or a tension pneumothorax. Distributive shock may be due to sepsis, anaphylaxis, injury to the upper spinal cord, or certain overdoses.</blockquote>
The American Academy of Pediatrics advised:<blockquote>When pain is prolonged, striking changes occur in the infant's physiologic and behavioral indicators. During episodes of prolonged pain, neonates enter a state of passivity with few, if any, body movements; an expressionless face; decreased heart rate and respiratory variability; and decreased oxygen consumption, all suggestive of a marked conservation of energy.<ref name="aap2016">{{REFjournal |last= Committee on Fetus and Newborn and Section on Surgery; Section on Anesthesiology and Pain Medicine;Canadian Paediatric Society; Fetus and Newborn Committee |etal=no |title=Prevention and Management of Pain in the Neonate: An Update |trans-title= |language= |journal=Pediatrics |location= |date=2006-11 |volume=118 |issue=5 |article= |page= |pages=2231–41 |url=https://publications.aap.org/pediatrics/article/118/5/2231/69964/Prevention-and-Management-of-Pain-in-the-Neonate?autologincheck=redirected |archived= |quote= |pubmedID=17079598 |pubmedCID= |DOI=10.1542/peds.2006-2277 |accessdate=2023-04-29}}</ref> <ref name="agoglu2022" /></blockquote>
=== Neurogenic shock ===
[[File:AmericanBabyInShockAfterCircumcision.jpg|thumb|American baby in shock after circumcision]]
|accessdate=2020-12-20
}}</ref>
== Hypovolemic shock ==
Every operation, including [[circumcision]], can lead to severe blood loss, which can lead to a “traumatic-hemorrhagic shock” (bleeding as a result of traumatic effects).
* [https://alphamom.com/wp-content/uploads/2010/05/wonderland_circumcision-e1273195287922.jpg alphamom.com: Circumcision: the kindest cut, or the cruelest?]
Infants regularly go into shock during [[circumcision]] due to the extreme [[pain]] they cannot escape and from which they cannot defend themselves (because of being restrained by a [[Circumstraint]] or because of being held by adults). <ref name="agoglu2022" /> This is their only way to turn off pain perception. Visible symptoms are usually very swollen eyelids and puffy faces after the intense screaming before. With some, the apathetic eyes do not close by themselves in shock.
=== "Felt nothing" ===
{{SEEALSO}}
* [[Breastfeeding]]
* [[Circumstraint]]
* [[Pain]]
* [[Trauma]]
[[Category:Breastfeeding]]
[[Category:Pain]]
[[Category:Parental information]]
[[Category:Trauma]]
[[de:Schock]]