Predicting Anxiety in Children Aged 2-6 During Preoperative Anesthesia Consultation-A Prospective Observational Study

Area of Science:

• Pediatric Anesthesiology
• Child Psychology

Background:

• Preoperative anxiety is common in young children (2-6 years) undergoing surgery.
• This anxiety can lead to adverse outcomes.
• Anesthesiologists often rely on limited preoperative interactions to predict a child's anxiety level.

Purpose of the Study:

• To evaluate the accuracy of early anxiety predictions made by anesthesiologists and parents.
• To identify early predictors of heightened anxiety at anesthesia induction in children.
• To improve preoperative anxiety management strategies.

Main Methods:

• Prospective observational study involving 92 children aged 2-6 years.
• Anesthesiologists and parents predicted child's anxiety using visual analog scale (VAS).
• Observed anxiety measured with Modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF); prediction accuracy assessed via correlation and ROC analysis.

Main Results:

• Weak correlation between predicted and observed anxiety for parents (rs=0.220) and very weak for anesthesiologists (rs=0.106).
• Predictive performance was limited for parents (AUC=0.643) and negligible for anesthesiologists (AUC=0.517).
• Positive response to a greeting ('high-five') correlated with significantly lower induction anxiety (p<0.001); younger age, migration background, and inhalational induction were associated with higher anxiety.

Conclusions:

• Preoperative anxiety prediction in children is imprecise for both parents and anesthesiologists.
• Simple behavioral cues, like a child's response to a greeting, may aid early identification of at-risk children.
• Individualized anxiety management strategies involving children and parents are recommended.