title: Preoperative preparation workshop reduces postoperative maladaptive behavior in children.
abstract: BACKGROUND
  Postoperative maladaptive behaviors (POMBs) are common following pediatric anesthesia, and preoperative anxiety is associated with POMBs. A family-centered preoperative preparation workshop was instituted with the aim of reducing the incidence of POMB and preoperative anxiety, and the study was constructed to evaluate its effectiveness.
  
  
  METHODS
  A prospective cohort study was constructed, comparing patients who attended the workshop (workshop group) with patients who did not attend and who were matched for age and type of surgery (comparison group). Preoperative anxiety was measured using the mYPAS score, postoperative emergence agitation (EA) was measured using the PAED score, POMBs were assessed with the Post-Hospital Behavior Questionnaire (PHBQ) on postoperative day 7, and PACU morphine consumption and PACU length of stay were recorded. Statistical analysis was performed employing the X² test, the Fisher's exact test, and the Mann-Whitney test as appropriate. Data were expressed as median [minimum, maximum].
  
  
  RESULTS
  Fifty-six patients from 3 to 18 years of age were recruited. Twenty-seven patients in the workshop group were compared to 26 in the comparison group, after exclusions for missing data. Significant differences were demonstrated between groups for POMBs intensity (PHBQ score 2 [0; 9] vs 5 [0; 10], P = 0.008) and incidence (PHBQ score >6: 3.6% vs 35.7%, P = 0.003), and for mYPAS score (28 [23; 87] vs 37 [23;100], P = 0.015). No difference was found for EA, PACU morphine consumption, or PACU length of stay.
  
  
  CONCLUSIONS
  The workshop appears to result in reduced preoperative anxiety and POMBs.
authors.affiliation: Department of Anesthesia, Intensive care, Robert Debré University Hospital, Paris Diderot University, Paris, France.|Denis Diderot University, Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Hilly
authors.affiliation: Department of Anesthesia, Intensive care, Robert Debré University Hospital, Paris Diderot University, Paris, France.|Denis Diderot University, Paris, France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Hörlin
authors.affiliation: Department of Anesthesia, Intensive care, Robert Debré University Hospital, Paris Diderot University, Paris, France.
authors.forename: Joelle
authors.initials: J
authors.lastname: Kinderf
authors.affiliation: Department of Anesthesia, Intensive care, Robert Debré University Hospital, Paris Diderot University, Paris, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Ghez
authors.affiliation: Denis Diderot University, Paris, France.|Department of Peadiatric Orthopedics, RobertDebré University Hospital, Paris Diderot University, Paris, France.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Menrath
authors.affiliation: Department of Pain Management, Robert Debré University Hospital, Paris Diderot University, Paris, France.|René Descarte University, Paris, France.
authors.forename: Honorine
authors.initials: H
authors.lastname: Delivet
authors.affiliation: Department of Anesthesia, Intensive care, Robert Debré University Hospital, Paris Diderot University, Paris, France.
authors.forename: Christopher
authors.initials: C
authors.lastname: Brasher
authors.affiliation: Department of Anesthesia, Intensive care, Robert Debré University Hospital, Paris Diderot University, Paris, France.|Denis Diderot University, Paris, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Nivoche
authors.affiliation: Department of Anesthesia, Intensive care, Robert Debré University Hospital, Paris Diderot University, Paris, France.|Denis Diderot University, Paris, France.|DHU PROTECT INSERM U 1141, Robert Debré University Hospital, Paris, France.
authors.forename: Souhayl
authors.initials: S
authors.lastname: Dahmani
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001007:Anxiety / Q000517:prevention & control* / Q000523:psychology; D002648:Child; D002652:Child Behavior / Q000523:psychology; D002675:Child, Preschool; D015331:Cohort Studies; D004493:Education / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control* / Q000523:psychology*; D011300:Preoperative Care / Q000379:methods / Q000523:psychology*; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000517:prevention & control* / Q000523:psychology
keywords: emergence agitation; pain; pediatric; postoperative; postoperative maladaptive behaviors