Predictors of Pre-operative Anxiety in Indian Children

Objective To identify the predictors of pre-operative anxiety in school-going children in India. Methods A prospective observational study was done at a tertiary care teaching hospital. Children aged 7-12 y scheduled for elective surgery and their parents were enrolled. Pre-operative anxiety in children and parents was assessed using STAI-C and STAI-P questionnaires respectively. The child's anxiety in pre-op room, at the time of parental separation and induction of anesthesia were assessed using m-YPAS scale. Possible predictors of anxiety under 'individual', 'social' and 'healthcare' domains were analyzed using logistic regression. The quality of mask induction of anesthesia was assessed using Induction Compliance Checklist. Results Sixty children completed the study successfully. Receiver operating characteristic (ROC) curve indicted mYPAS score >= 30 (observed score) to identify children with high anxiety as identified by STAI-C >= 37 (self-reported score). The incidence of high anxiety escalated from pre-operative time (48%) to the time of parental separation (72%) and increased further at anesthetic induction (95%). Parental anxiety (p = 0.03) and socioeconomic background (p = 0.03) were significant predictors of the child's pre-operative anxiety. The presence of >4 people at induction (p = 0.002), but not pre-operative anxiety, was found significantly more in children with poor quality of mask induction. Conclusions The incidence of peri-operative anxiety in Indian children is significant. Parental anxiety and socioeconomic background were found significant predictors of high pre-operative anxiety in our set-up.