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Online ISSN 1827-1596
Berghmans J. M. 1, 2, Poley M. 3, 4, Weber F. 2, Van De Velde M. 5, Adriaenssens P. 6, Klein J. 7, Himpe D. 1, Utens E. 8
1 Department of Anesthesia, ZNA Middelheim, Queen Paola Children’s Hospital, Antwerp, Belgium;
2 Department of Anesthesia, Erasmus Medical Centre, Sophia Children’s Hospital, Rotterdam, The Netherlands;
3 Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands;
4 Department of Pediatric Surgery, Erasmus MC Sophia Children’s Hospital, Rotterdam, The Netherlands;
5 Department of Anesthesiology, KU Leuven; University Hospital Gasthuisberg, Gasthuisberg, Belgium;
6 Department of Child Psychiatry, KU Leuven; University Hospital Gasthuisberg, Gasthuisberg, Belgium;
7 Faculty of Medicine and Health Sciences/Institute of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands;
8 Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre - Sophia Children’s Hospital, Rotterdam, The Netherlands
BACKGROUND: preoperative anxiety at induction and postoperative emergence delirium (ED) in children are associated with postoperative behavioral changes and adjustment disorders. This study’s aim is to assess the value of the Child Behavior Checklist (CBCL) score in order to predict anxiety during induction and emergence delirium after anesthesia in children undergoing elective day-care surgery.
METHODS: Anxiety at induction, assessed by the modified Yale Preoperative Anxiety Scale (mYPAS), was studied as outcome in 401 children (60.1% male, age range: 1.5-16 years). For 343 of these children (59.8% male, age range: 1.5-16 years) ED could be investigated postoperatively, as assessed by the Pediatric Anesthesia Emergence Delirium scale (PAED). Demographic data, healthcare contacts, anesthesia and surgical data were registered. Preoperative emotional/behavioral problems, during the 6 months prior to surgery, were assessed by the CBCL. Hierarchical, multiple regression was used to test whether anxiety and ED could be predicted by CBCL scores.
RESULTS: Children with a higher CBCL score on preoperative internalizing problems (e.g. anxious/depression) showed preoperative more anxiety at induction (P=0.003). A higher CBCL score on preoperative emotional/behavioral problems was not associated with ED.
CONCLUSION: The CBCL predicted anxiety at induction but not ED.