학술논문

Caregiver anxiety and the association with acute postoperative pain in children undergoing elective ambulatory surgery in a lower‐middle‐income country setting.
Document Type
Article
Source
Pediatric Anesthesia. Sep2020, Vol. 30 Issue 9, p990-997. 8p.
Subject
*AMBULATORY surgery
*ADENOTONSILLECTOMY
*POSTOPERATIVE pain
*ELECTIVE surgery
*VISUAL analog scale
*BECK Anxiety Inventory
*PSYCHOLOGICAL distress
Language
ISSN
1155-5645
Abstract
Background and aims: Moderate to severe postoperative pain complicates surgeries performed on children in upper‐income countries. The successful management of postoperative pain in children requires a biopsychosocial approach. Situational anxiety and anxiety disorders among caregivers influence a child's perioperative experience. This study aims to determine whether there is an association between caregiver's preoperative anxiety and children's postoperative pain in a lower‐middle‐income country (LMIC) setting. Methods: In this cross‐sectional, descriptive study, we recruited 76 children aged 4‐12 years, undergoing elective ambulatory tonsillectomy or adenotonsillectomy. Primary caregivers completed validated measures of anxiety (the Beck Anxiety Inventory [BAI] and the Kessler Psychological Distress Scale [K10]) prior to the children undergoing surgery. Postoperative pain was measured using the Wong‐Baker Faces Pain Rating Scale 4 hours after surgery. Results: Caregiver anxiety was found in 31.7% of participants using the K10 and in 42.1% using the BAI. Moderate to severe postoperative pain was reported by 51% of children. There was a statistically significant correlation of moderate strength between anxiety scores of caregivers and children's self‐reported postoperative pain scores (r =.47 for K10, r =.44 for BAI, P <.001 for both). Two median quantile regression models confirmed that K10 was positively associated with caregiver anxiety (WBFS) with slope = 0.16 and pseudo R2 = 0.25 (P =.002, 95CI: 0.06‐0.26) as was BAI with slope = 0.12 and pseudo R2 = 0.22 (P =.013 95CI: 0.03‐0.22). Conclusions: This study showed that preoperative caregiver anxiety is significantly associated with postoperative pain in children undergoing elective, ambulatory surgery in a LMIC setting (correlation of moderate strength). Interventions aimed at reducing caregiver anxiety should become an important component of the biopsychosocial management of postoperative pain in children. [ABSTRACT FROM AUTHOR]