• Honorine Delivet, Delphine Beauvais, Adelaide Mialot, Thomas Vacher, Lucile Marsac, Christopher Brasher, Daphné Michelet, and Souhayl Dahmani.
• Department of Pain Management, Robert Debré University Hospital, Paris Sorbonne Cité, Paris Diderot University, Paris, France.
• Paediatr Anaesth. 2018 Nov 1; 28 (11): 987-998.

BackgroundPreventive strategies are available to reduce preoperative anxiety in children, the ideal time for implementing such strategies remains poorly determined.AimsThe aim of this study was to determine psychological factors and events involved in the development of preoperative anxiety in children.MethodsThis study consisted of prospective evaluations of anxiety trait and state during the preoperative period. Attendance at a preanesthetic consultation is obligatory for all patients undergoing surgery in France. Anxiety trait and state assessments were quantified in mothers and children before and after the preanesthetic consultation using visual analog and faces numerical scales. Preoperative anxiety in children was assessed immediately before induction of anesthesia using an analog scale. Other data recorded included demographic and medical data and type of hospital stay. Univariate and multivariate logistic regression analyses were used.ResultsOverall 111 consecutive patients were included. The following factors emerged leading to anxiety state at induction of anesthesia: maternal anxiety state before the preanesthetic consultation, a feeling of not being reassured by the anesthesiologist, maternal anxiety state after the consultation, and anxiety trait in the child. Logistic regression found this combination of factors (OR = 4 [1.4 -12]) and inpatient stay (OR = 3 [1.4-7]), predicting anxiety with an accuracy of 69%.ConclusionThe present study identified a combination of psychological factors and events associated with the development of anxiety at induction of anesthesia in children. Parental anxiety impacts upon children and occurs before the preanesthetic consultation. This result may assist clinicians to prescribe personalized preventive strategies against anxiety.© 2018 John Wiley & Sons Ltd.

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