Children, surgery and anxiety study

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http://www.medicalnewstoday.com/medicalnews.php?newsid=18002

Children's anxiety prior to surgery linked to behavioral changes

18 Dec 2004

A child's level of anxiety prior to surgery is predictive of whether they will

experience post-surgical delirium and maladaptive behavioral changes, including

anxiety, nighttime crying, and bedwetting, according to a Yale study published

in the journal Anesthesia & Analgesia.

" This finding is of importance to the clinician, who can now better predict the

development of adverse postoperative phenomena in children based on the child's

preoperative anxiety, " said Zeev Kain, M.D., professor in the Department of

Anesthesiology at Yale School of Medicine and principal investigator of the

study.

Kain and his colleagues found children whose anxiety before surgery increased 10

percent based on the Yale Operative Anxiety Scale were 10 percent more likely to

experience delirium after surgery. Children with delirium also were more likely

to have one or more new maladaptive behavioral changes following surgery when

compared to children with no delirium. In addition, children with a 10 percent

increase in anxiety scores had a comparable increase in the likelihood that they

would have one or more new maladaptive behavioral changes following surgery,

among them separation anxiety and temper tantrums.

" We identified characteristics of children who are at high risk of developing

all of these clinical issues: they are younger, more emotional, more impulsive,

and less social, " Kain said. " In addition, the parents of these children are

significantly more anxious in the holding area and more anxious on separation to

the operating room. This underscores the importance of finding ways to ease this

parental anxiety, for example, by developing preoperative preparation programs

directed at parents. "

Co-authors include Alison Caldwell-s, Inna Maranets, M.D., McClain,

M.D., Dorothy Gaal, M.D., Mayes, M.D., Rui Feng, and Heping Zhang, all of

Yale.

Citation: Anesthesia & Analgesia, Vol. 99; pp 1648-54 (December 2004)