Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942006000600004
Brazilian Journal of Anesthesiology
Scientific Article

Estudo transversal de ansiedade pré-operatória em crianças: utilização da escala de Yale modificada

A transversal study on preoperative anxiety in children: use of the modified Yale scale

Álvaro Antônio Guaratini; José Álvaro Marques Marcolino; Ayrton Bentes Teixeira; Ricardo Caio Bernardis; Maria Lúcia Bastos Passarelli; Lígia Andrade da Silva Telles Mathias

http://dx.doi.org/10.1590/S0034-70942006000600004 Braz J Anesthesiol, vol.56, n6, p.591-601, 2006
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Resumo

JUSTIFICATIVA E OBJETIVOS: O emprego de escalas pode ser útil no reconhecimento dos estados de ansiedade, direcionando medidas que previnam complicações decorrentes de níveis elevados de ansiedade. A escala de ansiedade pré-operatória de Yale modificada (EAPY-m) foi desenvolvida para avaliação da ansiedade em crianças na idade pré-escolar no momento da indução da anestesia. Essa escala possui caráter observacional e é rápida de ser completada. Os estudos sobre ansiedade em crianças no período pré-operatório não fazem menção à ansiedade no momento da avaliação pré-anestésica ambulatorial (APA). Este estudo transversal procurou avaliar o nível e a prevalência de ansiedade no momento da APA e da consulta clínica utilizando a escala EAPY-m, em crianças em idade pré-escolar. MÉTODO: Foram selecionadas 100 crianças, estado físico ASA I e IIi: G PED = 50 crianças a serem submetidas à avaliação clínica; G APA = 50 crianças a serem submetidas à apa para programação cirúrgica. O estudo se desenvolveu na sala de espera dos ambulatórios de pediatria e de apa enquanto as crianças aguardavam as consultas. Dois observadores aplicaram a escala EAPY-m de forma independente. Os parâmetros analisados foram dados sociodemográficos; mediana e porcentagem de pacientes com ansiedade (EAPY-m > 30). Foi realizada a análise estatística, sendo considerado significativo p < 0,05. RESULTADOS: Os grupos foram homogêneos com relação aos dados sociodemográficos. As médias de idade foram: G PED 4,25 e G APA 4,67 anos. Observou-se diferença significativa da mediana da EAPY-m (G PED 23,4 e G APA 50,0) e da prevalência de ansiedade entre os dois grupos (G PED 16,7% e G APA 81,6%). CONCLUSÕES: Em crianças com idade entre 2 e 7 anos, os níveis e as prevalências de ansiedade, avaliados por meio da EAPY-m, no momento da avaliação pré-anestésica ambulatorial são maiores do que no momento da consulta clínica.

Palavras-chave

AVALIAÇÃO PRÉ-ANESTÉSICA, CIRURGIA, TÉCNICAS DE MEDIÇÃO

Abstract

BACKGROUND AND OBJECTIVES: Scales can be useful to recognize anxiety states and to indicate ways to prevent complications due to elevated levels of anxiety. The modified Yale Preoperative Anxiety Scale (YPAS-m) was developed to evaluate anxiety in preschool children at the time of the anesthetic induction. It is an observational scale, being applied and completed in a short period of time. Studies on anxiety in children in the preoperative period do not mention anxiety at the preanesthetic evaluation. This transversal study tried to evaluate the level and prevalence of anxiety at the preanesthetic evaluation and in the clinical evaluation using the YPAS-m in preschool children. METHODS: One hundred children, physical status ASA I and II were evaluated; G PED = 50 children undergoing clinical evaluation; G PEC = 50 children undergoing preanesthetic evaluation for surgery. The study was conducted at the pediatric clinic and preanesthetic evaluation waiting-room while the children waited for their appointment. Two observers applied the YPAS-m independently. Parameters analyzed included the demographic data; and median and percentage of patients with anxiety (YPAS-m > 30). Statistical analysis considered a p < 0.05 significant. RESULTS: The groups were homogenous regarding the socio-demographic data. The mean ages were: G PED 4.25 and G PEC 4.67 years. There was a significant difference in the median of the YPAS-m (G PED 23.4 and G PEC 50.0) and on the prevalence of anxiety between both groups (G PED 16.7% and G PEC 81.6%). CONCLUSIONS: In children between 2 and 7 years the levels and prevalence of anxiety, evaluated by the YPAS-m, at the time of the outpatient preanesthetic evaluation are higher than at the time of the clinical evaluation.

Keywords

PRE-ANESTHETIC EVALUATION, SURGERY, EVALUATION TECHNIQUES

References

Chernow B, Alexander HR, Smallridge RC. Hormonal responses to graded surgical stress. Arch Intern Med. 1987;147:1273-1278.

Linn BS, Linn MW, Klimas NG. Effects of psychophysical stress on surgical outcome. Psychosom Med. 1988;50:230-244.

Parris WC, Matt D, Jamison RN. Anxiety and postoperative recovery in ambulatory surgery patients. Anesth Prog. 1988;35:61-64.

Weissman C. The metabolic response to stress: an overview and update. Anesthesiology. 1990;73:308-327.

Lumley MA, Melamed BG, Abeles LA. Predicting children's presurgical anxiety and subsequent behavior changes. J Pediatr Psychol. 1993;18:481-497.

Kain ZN, Mayes LC, O'Connor TZ. Preoperative anxiety in children: Predictors and outcomes. Arch Pediatr Adolesc Med. 1996:1238-1245.

Kotiniemi LH, Ryhanen PT, Moilanen IK. Behavioural changes in children following day-case surgery: a 4-week follow-up of 551 children. Anaesthesia. 1997;52:970-976.

Aono J, Mamiya K, Manabe M. Preoperative anxiety is associated with a high incidence of problematic behavior on emergence after halothane anesthesia in boys. Acta Anaesthesiol Scand. 1999;43:542-544.

Maranets I, Kain ZN. Preoperative anxiety and intraoperative anesthetic requirements. Anesth Analg. 1999;89:1346-1351.

Quiles Sebastien MF, Mendez Carrillo F, Ortigosa Quiles J. Pre-surgical worries: an empirical study in the child and adolescent population. An Esp Pediatr. 2001;55:129-134.

Hagglof B. Psychological reaction by children of various ages to hospital care and invasive procedures. Acta Paediatr. 1999;88:72-78.

McClowry SG. The relationship of temperament to pre- and posthospitalization behavioral responses of school-age children. Nurs Res. 1990;39:30-35.

Thompson ML. Information-seeking coping and anxiety in school-age children anticipating surgery. Child Health Care. 1994;23:87-97.

Kain ZN, Mayes LC, Caramico LA. Parental presence during induction of anesthesia: A randomized controlled trial. Anesthesiology. 1996;84:1060-1067.

LaMontagne LL, Johnson JE, Hepworth JT. Attention, coping, and activity in children undergoing orthopaedic surgery. Res Nurs Health. 1997;20:487-494.

Kain ZN, Mayes LC, Weisman SJ. Social adaptability, cognitive abilities, and other predictors for children's reactions to surgery. J Clin Anesth. 2000;12:549-554.

Kain ZN. Premedication and parental presence revisited. Curr Opin Anesthesiol. 2001;14:331-337.

Stallings P, March JS. Assessment. Anxiety Disorders in Children and Adolescents. 1995:125-147.

March JS, Parker JD, Sullivan K. The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. J Am Acad Child Adolesc Psychiatry. 1997;36:554-565.

Greenhill LL, Pine D, March J. Assessment issues in treatment research of pediatric anxiety disorders: what is working, what is not working, what is missing, and what needs improvement. Psychopharmacol Bull. 1998;34:155-164.

Sadock Benjamin J., Sadock Virginia A. Kaplan & Sadock's Comprehensive Textbook of Psychiatry. 2005.

Kain ZN, Mayes LC, Cicchetti DV. Measurement tool for preoperative anxiety in young children: The Yale Preoperative Anxiety Scale. Child Neuropsychol. 1995;1:203-210.

Kain ZN, Mayes LC, Cicchetti DV. The Yale Preoperative Anxiety Scale: how does it compare with a "gold standard"?. Anesth Analg. 1997;85:783-788.

Mackenzie JW. Daycase anaesthesia and anxiety: A study of anxiety profiles amongst patients attending a day bed unit. Anaesthesia. 1989;44:437-440.

Macuco MV, Macuco OC, Bedin A. Efeito de um consultório de Anestesiologia sobre as preocupações, percepções e preferências relacionadas à anestesia: Comparação entre o sexo masculino e feminino. Rev Bras Anestesiol. 1999;49:179-189.

Wyatt SS, Jones DA, Peach MJ. Anxiety in patients having caesarean section under regional anaesthesia: a questionnaire and pilot study. Int J Obstet Anesth. 2001;10:278-283.

Palapattu GS, Haisfield-Wolfe ME, Walker JM. Assessment of perioperative psychological distress in patients undergoing radical cystectomy for bladder cancer. J Urol. 2004;172:1814-1817.

Hong JY, Jee YS, Luthardt FW. Comparison of conscious sedation for oocyte retrieval between low-anxiety and high-anxiety patients. J Clin Anesth. 2005;17:549-553.

Matsushita T, Matsushima E, Maruyama M. Anxiety and depression of patients with digestive cancer. Psychiatry Clin Neurosci. 2005;59:576-583.

Rivard AL, Hellmich C, Sampson B. reoperative predictors for postoperative problems in heart transplantation: psychiatric and psychosocial considerations. Prog Transplant. 2005;15:276-282.

Martins ALC, Geraldo Duarte SS, Martins RS. Midazolam como medicação pré-anestésica em pacientes pediátricos. Rev Bras Anestesiol. 1991;41:241-245.

Jones RD, Visram AR, Kornberg JP. Premedication with oral midazolam in children-an assessment of psychomotor function, anxiolysis, sedation and pharmacokinetics. Anaesth Intensive Care. 1994;22:539-544.

Pywell CA, Hung YJ, Nagelhout J. Oral midazolam versus meperidine, atropine, and diazepam: a comparison of premedicants in pediatric outpatients. AANA J. 1995;63:124-130.

Stocche RM, Garcia LV, Klamt JG. Medicação pré-anestésica com clonidina por via oral em cirurgia de catarata. Rev Bras Anestesiol. 2000;50:278-282.

Ghai B, Grandhe RP, Kumar A. Comparative evaluation of midazolam and ketamine with midazolam alone as oral premedication. Paediatr Anaesth. 2005;15:554-559.

Huber D, Kretz FJ. Efficacy of clonidine in paediatric anaesthesia. Anasthesiol Intensivmed Notfallmed Schmerzther. 2005;40:567-575.

Lam C, Udin RD, Malamed SF. Midazolam premedication in children: a pilot study comparing intramuscular and intranasal administration. Anesth Prog. 2005;52:56-61.

Caumo W, Broenstrub JC, Fialho L. Risk factors for postoperative anxiety in children. Acta Anaesthesiol Scand. 2000;44:782-789.

Moro ET, Modolo NSP. Ansiedade, a criança e os pais. Rev Bras Anestesiol. 2004;54:728-738.

Wollin SR, Plummer JL, Owen H. Predictors of preoperative anxiety in children. Anaesth Intensive Care. 2003;31:69-74.

Bevan JC, Johnston C, Haig MJ. Preoperative parental anxiety predicts behavioural and emotional responses to induction of anaesthesia in children. Can J Anaesth. 1990;37:177-182.

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