Preoperative Behavioral Stress in Children
Up to 60% of children between the ages of 1 and 10 that undergo outpatient surgery exhibit behavioral changes in the ensuing two weeks. These behaviors, like bed wetting, night terrors, and insomnia can, in large measure be predicted and to some extent ameliorated by the actions of clinicians during the preoperative period.
Important to the process is recognizing children at risk. Some of the characteristics that are associated with increased preoperative stress include:
1. Age - Children between the ages of 1 and 4 are especially frightened about the prospect of leaving their parents.
2. Prior surgical history - Children that have chronic diseases an/or have had multiple surgical procedures often have more anxiety than those for which the whole experience is new.
3. Temperament - Some children are timid, frighten easily and require more parental support for their age than other children. There is nothing wrong with having a temperament that is different. It is just an observation. We are all different, thankfully.
4. Anxious Parents - Children sense their parents anxieties
Once a clinician has identified a child at high risk for stress prior to the surgical procedure, and one senses these things while talking to the child - remember - always talk to the child - then make a decision about the pharmacological support that the child will need during the preoperative period and explain to the parents your assessment of the child's level of discomfort and what your approach will be. I try to explain every step in the process if I can . I find that parents appreciate candor and a gentle approach. It speaks to the comfort level that a clinician has and that, in turn reduces their level of anxiety.
Rae
Important to the process is recognizing children at risk. Some of the characteristics that are associated with increased preoperative stress include:
1. Age - Children between the ages of 1 and 4 are especially frightened about the prospect of leaving their parents.
2. Prior surgical history - Children that have chronic diseases an/or have had multiple surgical procedures often have more anxiety than those for which the whole experience is new.
3. Temperament - Some children are timid, frighten easily and require more parental support for their age than other children. There is nothing wrong with having a temperament that is different. It is just an observation. We are all different, thankfully.
4. Anxious Parents - Children sense their parents anxieties
Once a clinician has identified a child at high risk for stress prior to the surgical procedure, and one senses these things while talking to the child - remember - always talk to the child - then make a decision about the pharmacological support that the child will need during the preoperative period and explain to the parents your assessment of the child's level of discomfort and what your approach will be. I try to explain every step in the process if I can . I find that parents appreciate candor and a gentle approach. It speaks to the comfort level that a clinician has and that, in turn reduces their level of anxiety.
Rae
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