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Vieco-García A, López-Picado A, Fuentes M, Francisco-González L, Joyanes B, Soto C, Garcia de la Aldea A, Gonzalez-Perrino C, Aleo E. Comparison of different scales for the evaluation of anxiety and compliance with anesthetic induction in children undergoing scheduled major outpatient surgery. Perioper Med (Lond) 2021; 10:58. [PMID: 34903293 PMCID: PMC8670148 DOI: 10.1186/s13741-021-00228-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Anxiety in children triggered by a scheduled surgical intervention is a major issue due to its frequency and consequences. Preoperative anxiety is associated with increased patient fear and agitation on anesthetic induction. The aim of this study is to compare three preoperative anxiety scales for children undergoing elective outpatient surgery, and to correlate each of these tools with the degree of patient compliance on induction, as assessed by the Induction Compliance Checklist (ICC). METHODS An observational prospective study was performed on a cohort of children with ages between 2 and 16 years old, scheduled for outpatient surgery. Anxiety was assessed upon arrival to the hospital (M0), during transfer to the surgical unit (M1), and in the operating room during anesthetic induction (M2). Anxiety in the parents (measured with the State-Trait Anxiety Inventory, STAI) and in the children (measured with the Spence Anxiety Scale-Pediatric, SCAS-P, the State-Trait Anxiety Inventory Children, STAIC, and Modified Yale Preoperative Anxiety Scale, m-YPAS) was assessed. Compliance with anesthetic induction was assessed with ICC. RESULTS The study included 76 patients (72.4% male, median age 7.9 years). Anxiety scores (m-YPAS) increased as the moment of surgery approached, being greater at the entrance to the surgical unit (M0 = 26.1 ± 9.5; M1 = 31.8 ± 18.1; M2 = 33.5 ± 21.1). A strong correlation was found between ICC scale and m-YPAS at M1 (0.738) and M2 timepoints (0.794), but not with the rest of scales at M0. CONCLUSIONS Standard anxiety assessment scales do not predict the quality of anesthetic induction. m-YPAS scale can detect increasing anxiety in children as they approach the surgical procedure and this correlates strongly with a worse anesthetic induction, defined by higher score on ICC scale.
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Affiliation(s)
- Alberto Vieco-García
- Unidad de Cuidados Intensivos Pediátricos y Unidad de Recuperación Postanestésica, Servicio de Pediatría (6° planta sur), Hospital Clínico San Carlos, C/Profesor Martin Lagos s/n, 28040, Madrid, Spain.,Departamento de Pediatría y Neuropediatría, Clínica Universidad de Navarra, Campus Madrid, Madrid, Spain
| | - Amanda López-Picado
- Unidad de Investigación Clínica y Ensayos Clínicos, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.,Facultad de Salud, Universidad Internacional de La Rioja, Logroño, Spain
| | - Manuel Fuentes
- Unidad de apoyo metodológico a la Investigación, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Laura Francisco-González
- Unidad de Cuidados Intensivos Pediátricos y Unidad de Recuperación Postanestésica, Servicio de Pediatría (6° planta sur), Hospital Clínico San Carlos, C/Profesor Martin Lagos s/n, 28040, Madrid, Spain
| | - Belén Joyanes
- Unidad de Cuidados Intensivos Pediátricos y Unidad de Recuperación Postanestésica, Servicio de Pediatría (6° planta sur), Hospital Clínico San Carlos, C/Profesor Martin Lagos s/n, 28040, Madrid, Spain
| | - Carmen Soto
- Cirugía Pediátrica, Hospital Clínico San Carlos, Madrid, Spain
| | - Ana Garcia de la Aldea
- Unidad de Cuidados Intensivos Pediátricos y Unidad de Recuperación Postanestésica, Servicio de Pediatría (6° planta sur), Hospital Clínico San Carlos, C/Profesor Martin Lagos s/n, 28040, Madrid, Spain
| | | | - Esther Aleo
- Unidad de Cuidados Intensivos Pediátricos y Unidad de Recuperación Postanestésica, Servicio de Pediatría (6° planta sur), Hospital Clínico San Carlos, C/Profesor Martin Lagos s/n, 28040, Madrid, Spain. .,Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
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