Up to half of the more than 5 million children who undergo surgery in the United States each year feel significantly stressed and anxious prior to entering the operating room. This stress and anxiety affect more than just the period prior to operation, according to researchers from the Yale University School of Medicine in New Haven, Connecticut, who found that anxious children feel more pain, need to take more medicine, and have more sleep problems and anxiety during the post-surgical recovery period.
From July 1998 to January 2004, researchers followed 241 5- to 12-year-old kids undergoing tonsillectomy and adenoidectomy from 5 days before surgery until 2 weeks after. Before the surgery, the kids and their parents answered questions about the child's stress and feelings of anxiety. Immediately after surgery, parents and hospital personnel noted whether kids were agitated, thrashing, or crying as the effects of the anesthesia wore off and reported how much medication was needed to control pain. When the kids went home, parents and kids reported whether they experienced any continuing anxiety, eating problems, sleeping problems, and pain.
Immediately after surgery, nearly 10% of anxious children experienced agitation, crying, and thrashing as they emerged from anesthesia compared with only 2% of those without pre-op anxiety. Both during the hospital stay and the first 3 days at home, parents reported that anxious kids experienced significantly more pain, and once home, they needed to take significantly more codeine and acetaminophen compared with kids who didn't feel anxious prior to surgery.
Anxious kids also had more trouble getting to sleep and staying asleep once they went home from the hospital. Compared with those who had little or no anxiety, anxious kids also took longer to resume their eating habits after surgery.
What This Means to You. The results of this study indicate that anxiety in kids before surgery may be linked to more problems with pain and recovery after surgery. If your child is particularly anxious about an upcoming surgical procedure, make sure to discuss what will happen and what to expect after surgery; large bookstores often carry kid-friendly books that describe surgery and the health professionals who will help your child. Also, during the pre-operative visit, talk to the doctor or nurse about techniques, such as distraction or visualization, that may help alleviate anxiety and stress.
Source: Zeev N. Kain, MD; Linda C. Mayes, MD; Alison A. Caldwell-Andrews, PhD; David E. Karas, MD; Brenda C. McClain, MD; Pediatrics, August 2006.
Reviewed by: Steven Dowshen, MD
Date reviewed: September 2006
