title: Preoperative anxiety is associated with a high incidence of problematic behavior on emergence after halothane anesthesia in boys.
abstract: BACKGROUND
  In our clinical experience, children who are crying before anesthesia are more likely to show agitated behavior on emergence.
  
  
  METHODS
  One hundred and ten boys aged 3-6 years old (ASA 1) who underwent circumcision were studied. The children were assigned to one of two groups, depending on their attitude during induction: the anxious group and the calm group. Anesthesia was induced by inhalation of halothane in oxygen, and was maintained at 1% throughout surgery. For intra- and postoperative analgesia, caudal block with 0.5 ml/kg of 0.25% plain bupivacaine and topical infiltration with 1 to 2 ml of 1% lidocaine were provided for all patients. The incidence of delirium on emergence was compared between the groups.
  
  
  RESULTS
  We excluded 4 boys showing signs of incomplete pain relief. Twenty of 27 boys in the anxious group showed a significantly greater incidence of problematic behavior on emergence, compared to 5 of 79 in the calm group.
  
  
  CONCLUSIONS
  The boys who were anxious before anesthesia showed a significantly greater incidence of problematic behavior on emergence from halothane anesthesia, compared with the boys who were calm before anesthesia.
authors.affiliation: Department of Anesthesiology, Kochi Medical School, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Aono
authors.forename: K
authors.initials: K
authors.lastname: Mamiya
authors.forename: M
authors.initials: M
authors.lastname: Manabe
mesh_terms: D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001007:Anxiety / Q000150:complications*; D001364:Awareness / Q000502:physiology; D002045:Bupivacaine / Q000008:administration & dosage; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D002675:Child, Preschool; D002944:Circumcision, Male; D003448:Crying / Q000523:psychology; D003693:Delirium / Q000209:etiology; D006221:Halothane / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D011595:Psychomotor Agitation / Q000209:etiology*
chemical_list: D018685:Anesthetics, Inhalation; D000779:Anesthetics, Local; D008012:Lidocaine; D006221:Halothane; D002045:Bupivacaine