The Association between Preoperative Parental Anxiety and Emergence Agitation in Preschoolers

Abstract

Introduction: The preoperative distress and anxiety experienced by preschoolers are associated with an increased incidence of troubled recovery from anesthesia. However, influences of parental anxiety on children at different stages of the surgical processes are not clear. The aim of this study was to evaluate any existing association between preoperative parental anxiety and emergence agitation in a pediatric surgery population. Materials and Methods: A total of 60 children ASA class I or II, aged 3 -12 years old, undergoing adenotonsillectomy with sevoflurane, were included in the study. Before surgery, we used State-Trait Anxiety Inventory S-T (STAI S-T) to assess parental anxiety. Emergence agitation of the children was assessed with Watcha scale and recorded every 10 min of first 30 min of the postoperative period. Parents were contacted 24 hours after the surgery to evaluate their satisfaction, post operative pain and any side effect observed in the children. Results: Preoperatively, the mean STAI-S scores of mothers were significantly higher than those of fathers (p < 0.05). The details of surgery, anesthesia and length of hospital stay after surgery were found to be associated with these scores. The STAI-T scores of mothers and fathers were similar (p > 0.05). The children had the highest agitation scores at 10 th postoperative minutes with an incidence of 73.9%. There was no correlation between parental anxiety and emergence agitation. Logistic regression analysis showed that low educational level of the parent was the only independent factor for state anxiety (OR: 8.96, 95% CI: 1.50 -40.35, p = 0.030). Discussion: In this study, we observed that education level of the parents might affect their preoperative anxiety. The factors influential in parental anxiety were not correlated with pediatric emergence agitation in this study.

Factors Related to Anxiety in Paediatric Patients and Their Parents before and after a Modified Ravitch Procedure—A Single-Centre Cohort Study

“…Moreover, it seems that the gender of the children also influences the anxiety in parents during the postoperative period: the mothers of girls were more anxious than the parents of boys. Similar gender-reliant patterns, but during the preoperative period, were observed by Charana et al [ 28 ] and Erkılıc et al [ 37 ]. Women’s greater vulnerability to anxiety can be partly rationalised by genetic factors, hormonal influences and sociocultural influences [ 38 ].…”

Heightened anxiety state among parents of sick children attending emergency department using State‐Trait Anxiety Inventory

“…This is in contrast with reported levels of anxiety in non‐acute setting 17–20 . These include parents of a child who underwent elective surgery 17 , 18 and parents of a child seen in the cardiology clinic for heart murmurs 19 …”

“…Save‐Pédebos et al 15 reported higher mean state anxiety score among parents with a child who had the first episode of seizure, 58.7; while parents with febrile children had lower state anxiety score, 50.1 16 . This is in contrast with reported levels of anxiety in non‐acute setting 17–20 . These include parents of a child who underwent elective surgery 17 , 18 and parents of a child seen in the cardiology clinic for heart murmurs 19 …”

“…16 This is in contrast with reported levels of anxiety in non-acute setting. [17][18][19][20] These include parents of a child who underwent elective surgery 17,18 and parents of a child seen in the cardiology clinic for heart murmurs. 19 As expected, the cross-section of the study population has a high proportion of parents with clinically detectable anxiety.…”

The effect of telephone counseling and internet-based support on pain and recovery after tonsil surgery in children – a systematic review

“…Not only pain, but also anxiety is a common problem postoperatively as patients/parents report high levels of anxiety prior to and after tonsillectomy ( Erkılıc et al., 2016 ). The result in Yang et al., (2016) , where the children in the group that received text messages were less anxious than those in the control group, is supported by a study where they conducted a quality improvement project to develop a text messaging service to deliver messages to paediatric tonsillectomy patients to improve communication and overall experience Newton and Sulman (2016) .…”