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Risk factors for postoperative anxiety in children

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Anxiety is defined as a set of behavioural manifestations that can be divided into state- and trait-anxiety. State-anxiety is a transitory emotional condition that varies in intensity and fluctuates over time. Trait-anxiety is a personality trait which remains relatively stable over time. The objective of this study was to identify and quantify perioperative risk factors for immediate postoperative anxiety in children.


A prospective cohort study was performed with 90 schoolchildren, ages ranging from 7 to 13 years old, ASA physical status I–II, submitted to elective surgery. The measuring instruments were verbal scale of pain, visual analogue scale (VAS), Trait-State Anxiety Inventory for Children (STAIC), Trait-State Anxiety Inventory (STAI) for parents, and structured questionnaire.


Patients not submitted to analgesic block and patients with moderate and intense pain presented an estimated risk 5- and 13-fold greater for high levels of postoperative state-anxiety, respectively. High levels of preoperative state-anxiety and administration of doses of midazolam less than 0.056 mg · kg-1 constituted an estimated risk for postoperative state-anxiety of 3- and 4-fold, respectively. A positive history of previous surgery was associated with lower risk for postoperative anxiety.


High levels of preoperative state-anxiety, administration of less than 0.056 mg · kg-1 of midazolam, absence of analgesic block and presence of moderate and intense postoperative pain constituted risk factors for immediate postoperative state-anxiety in children. Previous surgery reduced the risk for postoperative anxiety.

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Keywords: Anxiety; analgesic block; children; pain

Document Type: Original Article

Affiliations: 1: Serviço de Anestesia do Hospital de Clínicas de Porto Alegre, 2: Instituto de Psicologia and 3: Departamento de Farmacologia do Instituto de Ciências Básicas da Saúde da Universidade Federal do Rio Grande do Sul (UFRGS), Brazil

Publication date: 2000-08-01

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