The Correlation Between Preoperative Anxiety And Postoperative Pain Levels In Children With Burns

Background and Objective:Children with burns often require multiple surgical treatments.Anxiety is the most common preoperative psychological stress reaction.Moderate to severe postoperative pain may happen,which affects the prognosis of burned children.At present,domestic and foreign studies on the correlation between preoperative anxiety and postoperative pain are mainly aimed at adult patients and children undergoing tonsillectomy.While there were few descriptive studies on children with burns.The purpose of this study was to evaluate the preoperative anxiety and postoperative pain level of children with burns.Furthermore,we intend to explore the correlation between preoperative anxiety and postoperative pain in burned children,so as to provide basis for effective intervention of postoperative pain in clinical work.Methods:Ninety-three burned children who underwent surgery treatment under general anesthesia were enrolled in the descriptive study.On the day before surgery,one of the children’s parents completed the Trait Anxiety Inventory(TAI)and filled out the general information and disease information questionnaires.On the surgery day,the State Anxiety Inventory(SAI)was completed by the same parent.Children’s anxiety level in the operating room were evaluated by one anesthesiologist using the modified Yale preoperative anxiety scale(m-YDAS).The pain status of children was evaluated in 5 time points including in post-anesthesia care unit(PACU),4 hours,24 hours,48 hours and 72 hours after surgery.The FLACC Scale and Wong-Baker FACES Rating Scale were used for evaluating for children 1 to 3 years old and 4 to 12 years old respectively.Results:(1)The incidence of preoperative high anxiety in burned children was 61.3%.The preoperative anxiety scores of children aged 1 to 3 were significantly higher than those of children aged 4 to 12 years,the difference was statistically significant(P<0.05).The age and preoperative anxiety score were negatively correlated,and the difference was statistically significant(r =-0.241,P<0.05).(2)The pain scores of children aged 4 to 12 were higher than children aged 1 to 3,and the differences of pain scores at 4h,24 h,48h,and 72 h after surgery were statistically significant(P<0.001).(3)The results ofthe generalized linear model showed that postoperative pain scores were related to the age,burn size,burn depth and preoperative anxiety of burned children,and the differences were statistically significant(P<0.05).The age increased,the postoperative pain level in children with burns increased;the larger the burn size was,the higher the pain score was;the postoperative pain level in children with deep second-degree burns was higher than that in III-degree burns;the higher the preoperative anxiety score in children was,the higher the postoperative pain level was.(4)Children’s preoperative anxiety was positively correlated with parents’ trait anxiety,and the difference was statistically significant(P<0.05).Conclusion:The incidence of preoperative anxiety was high in burned children,especially in younger children.The incidence of moderate to severe postoperative pain was high and the pain level gradually decreased over time.The age increased,the postoperative pain level in children with burns increased;the larger the burn area was,the higher the pain score was;the postoperative pain level in children with deep II-degree burns was higher than that in III-degree burns;the higher the preoperative anxiety level in children was,the higher the postoperative pain score was.