Journal
ANESTHESIA AND ANALGESIA
Volume 109, Issue 3, Pages 737-744Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1213/ane.0b013e3181af00e4
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- University Hospital Center for Clinical Research, Program 2003, Montpellier, France
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BACKGROUND: Because children's anxiety influences pain perception, perioperative anxiety should be evaluated in clinical practice with a unique, useful, and valid tool to optimize pain management. In this study, we evaluated psychometric properties of the visual analog scale (VAS)-anxiety for children and to study its perioperative relevance in clinical practice. METHODS: One hundred children scheduled for elective surgery and general anesthesia were included. VAS-anxiety was measured at four timepoints and compared with both versions of State Spielbergers' questionnaires (State-Trait Anxiety Inventory for Youth [STAIY] and State-Trait Anxiety Inventory for Children [STAIC]) and the modified Yale Preoperative Anxiety Scale. Children's pain, parents' anxiety, and parents' proxy report of children's anxiety were evaluated using VAS. RESULTS: The correlation between STAIC and VAS-anxiety was significant oil the day of discharge. Moreover, changes over time were not significant with STAIC, whereas VAS-anxiety was significantly sensitive to changes over time in the two groups of age (7-11 yr and 12-16 yr). A receiver operating characteristic curve, using modified Yale Preoperative Anxiety Scale as reference, determined a VAS-anxiety cutoff at 30 to identify high-anxiety groups. Pain levels were significantly higher when children were anxious (VAS >= 30) in the postoperative period. Moreover, children's anxiety and pain were higher when parents were anxious. CONCLUSION: VAS-anxiety is a useful and valid tool to assess perioperative anxiety in children aged 7-16 yr. The influence of children's and parents' anxiety on children's postoperative pain suggests that VAS-anxiety should be recommended routinely for postoperative clinical practice to optimize anxiety and pain management. (Anesth Analg 2009;109:737-44)
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