[Preoperatory anxiety in children: psychological evaluation of premedication and parental presence efficacy]

Abstract

Objectives: The induction of anaesthesia for surgery is a stressful event for child. To treat pre-operative anxiety in children pharmalogical methods (premedication) and behavioural methods (the presence of parents during the induction of anesthesia) are used in combination with each other. The purpose of this investigation was to study the effect of two interventions to alleviate preoperative anxiety of 39 children who are undergoing minor surgery. We studied the influence of some psichological and social characteristics of child and parents on operative period.

Methods: We studied 39 italian speaking children aged 2-14 years ASA 1. We used STAI, a semi structured interview, with questions in the social-demographical area, a valuation scale of the behaviour of the child completed by the anesthesist, a questionaire after surgery for the parent. The descriptive analysis has been performed taking into account the nature of variables (frequency distributions for nominal and ordinal variables; means and standard deviations for cardinal variables).

Results: The results show that the age of the child is strongly conditional to the level of stress: negative reactions are more usual in children of pre-school age. The sedative premedication is not an important factor in relieving anxiety, and this result contrasts with published studies, stating the premedication is more effective than presence of a parent. We obtained interesting results by relating the level of stress in the child with other variables: which parent, the level of stress according to the STAI, level of education, type of residence of parents.

Conclusions: Mother's presence during induction resulted of paramount importance. This study shows that the premedication alone is not effective. Some social-demographical factors of the parents have influence.