Preoperative anxiety and emergence delirium and postoperative maladaptive behaviors

Area of Science:

• Pediatric Anesthesiology
• Child Psychology
• Surgical Outcomes

Background:

• Preoperative anxiety, emergence delirium, and postoperative behavioral changes are common in children.
• Previous research suggests a potential link between these phenomena.
• Understanding these relationships can improve pediatric perioperative care.

Purpose of the Study:

• To investigate the relationship between preoperative anxiety, emergence delirium, and postoperative maladaptive behavioral changes in children.
• To quantify the impact of preoperative anxiety on the likelihood of emergence delirium and behavioral changes.
• To provide clinicians with data for predicting adverse postoperative events.

Main Methods:

• Prospective study of children undergoing surgery with sevoflurane anesthesia.
• Assessment of preoperative anxiety using the modified Yale Preoperative Anxiety Scale (mYPAS).
• Evaluation of emergence delirium in the postanesthesia care unit and behavioral changes using the Post Hospital Behavior Questionnaire (PHBQ) up to 14 days post-surgery.

Main Results:

• A 10-point increase in mYPAS state anxiety score correlated with a 10% increase in the odds of marked emergence delirium.
• Children with marked emergence delirium had 1.43 times higher odds of new-onset postoperative maladaptive behavioral changes.
• Each 10-point increase in preoperative anxiety scores increased the likelihood of new-onset postoperative behavioral changes by 12.5%.

Conclusions:

• Preoperative anxiety is a significant predictor of emergence delirium and subsequent maladaptive behavioral changes in pediatric surgical patients.
• Clinicians can utilize preoperative anxiety levels to anticipate and potentially mitigate adverse postoperative outcomes.
• Targeting preoperative anxiety management may reduce the incidence of emergence delirium and behavioral disturbances.