To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Quality Of Children's Pre-operative Experiences Has Impact On Behavior URL: http://www.pslgroup.com/dg/3E996.htm Doctor's Guide October 20, 1997
SAN DIEGO, CA. -- October 20, 1997 -- A child's experiences immediately before surgery can directly alter the youngster's behavior for days, weeks and even months, after going home, according to the results of two Yale University studies presented at the annual meeting of the American Society of Anesthesiologists. The more positive the experience, the less likely the child is to exhibit a variety of negative behavioral responses days, weeks and months later, the studies found. These after-effects can include nightmares, eating problems, separation anxiety, apathy, withdrawal, escalated fear of physicians and increased rebelliousness toward parents and guardians, according to Zeev Kain, M.D., associate professor of anesthesiology and pediatrics at Yale. "That is why it is important to make this preoperative experience as comfortable as possible," Dr. Kain said. "An unpleasant experience can cause unnecessary hardship for children and parents alike." In one of the studies, researchers found giving a child a sedative before the induction, or start, of anesthesia can reduce the incidence of negative behavior after surgery by making the pre-operative experience more comfortable. The sedative not only lessens anxiety but also produces amnesia so the child is relaxed and does not remember anything unpleasant before surgery. In the study, 75 children ranging from two to seven years of age were given either a sedative or a placebo. The researchers then rated their behavior during the induction of anesthesia, in recovery and on the first, second, third, seventh and 14th days following surgery. "The more positive pre-operative experience produced more positive post-operative behavior," Dr. Kain said. The second study found children who were calm during the induction of anesthesia showed significantly fewer negative behavioral changes in the two weeks after surgery than did children who had a stormy induction and were very upset. The researchers rated the distress levels of 44 children in the pre-operative holding area, during the induction of anesthesia and on post-operative days one, two, three, seven and 14. None of the children received a sedative. Children's distress during the induction of anesthesia was directly related to later post-operative behavior, even after factoring in such variables as age, temperament and level of post-operative pain. The study results showed children who were more upset before surgery were more likely to develop nightmares, separation anxiety and eating disorders after surgery, Dr. Kain reported. To support children through surgery and its aftermath, Dr. Kain advises parents to request a pre-operative sedative for their child and to ask for permission to accompany their child into the operating room for the induction of anesthesia. "Check to see what your hospital's policy is for pediatric surgery," he said. He also advises parents to anticipate some behavioral changes in their children after surgery, which can be treated with a little extra compassion and patience. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.