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Updated: Jul 22, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Incidence and risk factors associated with negative postoperative behavioral changes in children undergoing painless
Pu YanYing1, Liu ShenLing1, Peng XiaoHan1
1Sedation and Analgesia Center, Kunming Children's Hospital, Kunming, China.
Insights
Negative postoperative behavioral changes (NPOBCs) occurred in 14.13% of children after painless gastroscopy, decreasing over time. Severe anxiety in children, female sex, and parental anxiety were key risk factors for these changes.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Ambulatory Surgery Outcomes
Background:
- Negative postoperative behavioral changes (NPOBCs) can impact pediatric recovery.
- Painless gastroscopy is a common procedure in children, necessitating an understanding of potential adverse behavioral effects.
Purpose of the Study:
- To determine the incidence of NPOBCs in children undergoing painless gastroscopy.
- To identify risk factors associated with NPOBCs in this pediatric population.
Main Methods:
- Prospective observational cohort study including 1,670 children aged 6-12 years (ASA I-II).
- Exclusion criteria included prior surgery/anesthesia, developmental abnormalities, and high preoperative pain scores.
- The Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) assessed NPOBCs on days 1, 14, and 30 post-procedure.
Main Results:
- Incidence rates of NPOBCs were 14.13% (day 1), 4.55% (day 14), and 2.14% (day 30).
- Risk factors included female sex, parental anxiety, and severe child anxiety (day 1); parental anxiety, higher parental education, and severe child anxiety (day 14); female sex, only child status, higher parental education, and severe child anxiety (day 30).
- Severe preoperative anxiety in children emerged as a consistent risk factor throughout the 30-day period.
Conclusions:
- NPOBCs following painless gastroscopy are relatively common initially but decrease significantly over 30 days.
- Key risk factors for NPOBCs include severe child anxiety, female sex, parental anxiety, and parental educational background.
- Addressing preoperative anxiety in children is crucial for mitigating NPOBCs.
Objective:
To investigate the incidence of and risk factors associated with negative postoperative behavioral changes (NPOBCs) in children undergoing painless gastroscopy.
Methods:
Inclusion criteria: ASA I-II and outpatients aged 6-12 years undergoing painless gastroscopy.
Exclusion Criteria:
history of surgery or anesthesia, children with developmental or intellectual abnormalities, refusal to participate, preoperative abdominal pain score > 3 points, history of chronic abdominal pain of > 3 months duration, and serious intraoperative complications. On the 1st, 14th, and 30th day after the gastroscopy, the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) was used to assess NPOBCs in children.
Results:
A total of 1,670 children were included in this prospective observational cohort study. The incidence rates of NPOBCs were 14.13%, 4.55%, and 2.14% on the 1st, 14th, and 30th day after gastroscopy, respectively. The risk factors for the first day were female sex (OR 1.34, 95% CI 1.00-1.79), parental anxiety (OR 2.23, 95% CI 1.75-3.12), and severe anxiety in children (OR 2.83, 95% CI 1.96-4.07). The risk factors on the 14th day were parental anxiety (OR 3.71, 95% CI 2.19-6.29), a parental educational level above high school (OR 1.65, 95% CI 1.00-2.70), and severe anxiety in children (OR 11.87, 95% CI 5.85-24.07). The risk factors on the 30th day were female sex (OR 2.99, 95% CI 1.41-6.34), being an only child (OR 4.42, 95% CI 2.18-8.95), a parental educational level above high school (OR 2.66, 95% CI 1.27 NPOBCs 5.56), and severe anxiety in children (OR 6.84, 95% CI 2.84-16.49).
Conclusion:
In children undergoing painless gastroscopy, the incidence rates of NPOBCs on the 1st, 14th, and 30th day were 14.13%, 4.55%, and 2.14%, respectively. The risk factors for NPOBCs were severe anxiety in children, female sex, parental anxiety, and a parental educational level above high school. In particular, severe preoperative anxiety in children was a persistent risk factor for NPOBCs within 30 days.
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