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Assessment of potential predictors affecting preoperative anxiety in Indian children- A prospective observational

Preethy J Mathew1, Arun M Gopinath2, Aakriti Gupta1

  • 1Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Journal of Anaesthesiology, Clinical Pharmacology
|August 11, 2023
PubMed

Insights

Preoperative anxiety is very common in Indian children aged 2-6 years undergoing surgery, escalating during anesthesia induction. The presence of siblings emerged as a key predictor of this anxiety.

Area of Science:

  • Pediatric Anesthesiology
  • Child Psychology
  • Surgical Patient Care

Background:

  • Preoperative anxiety is a significant concern for children scheduled for surgery.
  • Understanding its incidence and predictors in Indian pediatric populations is crucial for targeted interventions.

Purpose of the Study:

  • To determine the incidence of preoperative anxiety in Indian children aged 2-6 years.
  • To identify predictors of preoperative anxiety in this demographic.

Main Methods:

  • A prospective observational study involving 60 children (ASA Physical Status 1/2, aged 2-6 years).
  • Anxiety assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) at multiple time points.
  • Parental anxiety measured with the State-Trait Anxiety Inventory.
  • Logistic regression used to identify anxiety predictors.

Main Results:

  • High incidence of preoperative anxiety observed: 76% in the preoperative room, 93% at parental separation, and 96% during anesthetic induction.
  • The presence of siblings was identified as a significant independent predictor of preoperative anxiety (P = 0.04).
  • Excellent inter-rater agreement (weighted Kappa = 0.79) for mYPAS by anesthesiologist and psychologist.

Conclusions:

  • Indian children aged 2-6 years exhibit a very high incidence of preoperative anxiety.
  • Anxiety levels increase significantly during parental separation and anesthetic induction, even with sedative premedication.
  • Sibling presence is a notable predictor requiring consideration in preoperative anxiety management strategies.
Abstract

Keywords:
Pediatric anesthesiapredictors of anxietypreoperative anxiety

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