Risk factors for postoperative anxiety in children

Background: Anxiety is defined as a set of behavioural manifestations that can be divided into state- and trait-anxiety. State-anxiety is a transitory emotional condition that varies in intensity and fluctuates over time. Trait-anxiety is a personality trait which remains relatively stable over time. The objective of this study was to identify and quantify perioperative risk factors for immediate postoperative anxiety in children Methods: A prospective cohort study was performed with 90 schoolchildren, ages ranging from 7 to 13 years old, ASA physical status I-II; submitted to elective surgery. The measuring instruments were verbal scale of pain, visual analogue scale (VAS), Trait-State Anxiety Inventory for Children (STAIC), Trait-State anxiety Inventory (STAI) for parents, and structured questionnaire. Results: Patients not submitted to analgesic block and patients with moderate and intense pain presented an estimated risk 5- and 13-fold greater for high levels of postoperative state-anxiety, respectively. High levels of preoperative stab-anxiety and administration of doses of midazolam less than 0.056 mg . kg(-1) constituted an estimated risk for postoperative state-anxiety of 3- and 4-fold, respectively A positive history of previous surgery was associated with lower risk for postoperative anxiety. Conclusions: High levers of preoperative state-anxiety, administration of less than 0.056 mg . kg(-1) of midazolam, absence of analgesic block and presence of moderate and intense postoperative pain constituted risk factors for immediate postoperative state-anxiety in children. Previous surgery reduced the risk for postoperative anxiety.