Managing Children’s Anxiety Before and After Surgery

The prospect of surgery for a child is a frightening unknown for child and parent alike, and the pre-operative process that most children go through only heightens their anxiety. Research on how hospitals can minimize the anxiety and trauma children face both before and after surgery was recently published in the journal Anesthesiology.

Imagine you are a four-year-old. A total stranger takes you from your mother’s arms, then stabs you with a needle. Then another stranger puts a mask over your face. This happens every day in hospitals all over the country, leading to extremely high levels of anxiety for children after their operation: experts estimate that 50% of children who undergo general anesthesia have mental distress after the operation—everything from night terrors to longer-lasting emotional issues.

UC Irvine Department of Anesthesiology and Perioperative Care chairman Zeev Kain, M.D., has conducted extensive research to find ways to help minimize the anxiety and emotional trauma children face.

As a result of that research, parents are now allowed in the operating room to hold small children while anesthesia is being administered in many hospitals in the US, and sedative premedication is now given to many children prior to surgery, thus decreasing the stress of separation from the parents. And parents are allowed in recovery rooms so they are there when their child wakes up.

Dr. Kain has also examined whether administering hormones before surgery can have an impact on post-operative anxiety. He recently published a study in the journal Anesthesiology looking at how the use of melatonin prior to surgery affects the more than three million children aged 2-8 who have surgery each year. His research found that while 25% of children who underwent surgical procedures while under general anesthesia had an episode of post-operative hysteria (also known as “emergence delirium”), among children who received melatonin prior to their operation, that number dropped to five percent.

“Emergence delirium in children is not only frightening for parents, it can also lead to the development of behavioral changes beyond the recovery period, including nightmare, bed wetting, and separation anxiety,” said Dr. Kain. “With more than three million children undergoing major surgery every year, anything we can do to minimize their trauma, and increase parents’ piece of mind, is a significant breakthrough.”

The full article is available online at:
http://journals.lww.com/anesthesiology/Fulltext/2009/07000/Preoperative_Melatonin_and_Its_Effects_on.13.aspx
For more information on the UCI Department of Anesthesiology and Perioperative Care go to http://www.anesthesiology.uci.edu/

Source: University of California Irvine, Department of Anesthesiology and Perioperative Care