Risk factors for postoperative anxiety in children.
BACKGROUND
Anxiety is defined as a set of behavioural manifestations that can be divided into state- and trait-anxiety. State-anxiety is a transitory emotional condition that varies in intensity and fluctuates over time. Trait-anxiety is a personality trait which remains relatively stable over time. The objective of this study was to identify and quantify perioperative risk factors for immediate postoperative anxiety in children.


METHODS
A prospective cohort study was performed with 90 schoolchildren, ages ranging from 7 to 13 years old, ASA physical status I-II, submitted to elective surgery. The measuring instruments were verbal scale of pain, visual analogue scale (VAS), Trait-State Anxiety Inventory for Children (STAIC), Trait-State Anxiety Inventory (STAI) for parents, and structured questionnaire.


RESULTS
Patients not submitted to analgesic block and patients with moderate and intense pain presented an estimated risk 5- and 13-fold greater for high levels of postoperative state-anxiety, respectively. High levels of preoperative state-anxiety and administration of doses of midazolam less than 0.056 mg x kg(-1) constituted an estimated risk for postoperative state-anxiety of 3- and 4-fold, respectively. A positive history of previous surgery was associated with lower risk for postoperative anxiety.


CONCLUSIONS
High levels of preoperative state-anxiety, administration of less than 0.056 mg x kg(-1) of midazolam, absence of analgesic block and presence of moderate and intense postoperative pain constituted risk factors for immediate postoperative state-anxiety in children. Previous surgery reduced the risk for postoperative anxiety.
Caumo
W
W
Serviço de Anestesia do Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil.
Broenstrub
J C
JC
Fialho
L
L
Petry
S M
SM
Brathwait
O
O
Bandeira
D
D
Loguercio
A
A
Ferreira
M B
MB
D000758:Anesthesia; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000523:psychology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000523:psychology*; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors