Risk factors for postoperative anxiety in children

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Abstract
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 · 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 · 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.

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