The Korean Journal of Pain

  • 제28권4호
  • /
  • Pages.244-253
  • /
  • 2015
  • /
  • 2005-9159(pISSN)
  • /
  • 2093-0569(eISSN)
대한통증학회 (The Korean Pain Society)
권호 표지
DOI QR코드

DOI QR Code

Predictive Factors of Postoperative Pain and Postoperative Anxiety in Children Undergoing Elective Circumcision: A Prospective Cohort Study

  • 투고 : 2015.06.10
  • 심사 : 2015.08.31
  • 발행 : 2015.10.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. Methods: We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial plasty technique (PP), and conventional circumcision (CC). Demographics and base-line clinical characteristics were collected, and assessment of the level of preoperative anxiety was performed. Subsequently, a statistical model was designed in order to examine predictive factors of postoperative pain and postoperative anxiety. Assessment of postoperative pain was performed using the Faces Pain Scale (FPS). The Post Hospitalization Behavior Questionnaire study was used to assess negative behavioral manifestations. Results: A total of 301 children with a mean age of $7.56{\pm}2.61$ years were included in the study. Predictive factors of postoperative pain measured with the FPS included a) the type of surgical technique, b) the absence of siblings, and c) the presence of postoperative complications. Predictive factors of postoperative anxiety included a) the type of surgical technique, b) the level of education of mothers, c) the presence of preoperative anxiety, and d) a history of previous surgery. Conclusions: Although our study was not without its limitations, it expands current knowledge by adding new predictive factors of postoperative pain and postoperative anxiety. Clearly, further randomized controlled studies are needed to confirm its results.

키워드

참고문헌

  1. Beyaz SG. Comparison of postoperative analgesic efficacy of caudal block versus dorsal penile nerve block with levobupivacaine for circumcision in children. Korean J Pain 2011; 24: 31-5. https://doi.org/10.3344/kjp.2011.24.1.31
  2. Tree-Trakarn T, Pirayavaraporn S. Postoperative pain relief for circumcision in children: comparison among morphine, nerve block, and topical analgesia. Anesthesiology 1985; 62: 519-22. https://doi.org/10.1097/00000542-198504000-00027
  3. Wollin SR, Plummer JL, Owen H, Hawkins RM, Materazzo F, Morrison V. Anxiety in children having elective surgery. J Pediatr Nurs 2004; 19: 128-32. https://doi.org/10.1016/S0882-5963(03)00146-5
  4. Ader R, Cohen N, Felten D. Psychoneuroimmunology:interactions between the nervous system and the immune system. Lancet 1995; 345: 99-103. https://doi.org/10.1016/S0140-6736(95)90066-7
  5. Caumo W, Broenstrub JC, Fialho L, Petry SM, Brathwait O, Bandeira D, et al. Risk factors for postoperative anxiety in children. Acta Anaesthesiol Scand 2000; 44: 782-9. https://doi.org/10.1034/j.1399-6576.2000.440703.x
  6. Bonica JJ. The need of a taxonomy. Pain 1979; 6: 247-8. https://doi.org/10.1016/0304-3959(79)90046-0
  7. Beesdo K, Knappe S, Pine DS. Anxiety and anxiety disorders in children and adolescents: developmental issues and implications for DSM-V. Psychiatr Clin North Am 2009; 32:483-524. https://doi.org/10.1016/j.psc.2009.06.002
  8. Kain ZN, Mayes LC, Cicchetti DV, Bagnall AL, Finley JD, Hofstadter MB. The Yale Preoperative Anxiety Scale: how does it compare with a "gold standard"? Anesth Analg 1997; 85: 783-8. https://doi.org/10.1213/00000539-199710000-00012
  9. Cumino Dde O, Cagno G, Goncalves VF, Wajman DS, Mathias LA. Impact of preanesthetic information on anxiety of parents and children. Braz J Anesthesiol 2013; 63: 473-82. https://doi.org/10.1016/j.bjan.2013.04.001
  10. Christianakis E. Sutureless prepuceplasty with wound healing by second intention: an alternative surgical approach in children's phimosis treatment. BMC Urol 2008; 8: 6. https://doi.org/10.1186/1471-2490-8-6
  11. Cuckow PM, Rix G, Mouriquand PD. Preputial plasty: a good alternative to circumcision. J Pediatr Surg 1994; 29: 561-3. https://doi.org/10.1016/0022-3468(94)90092-2
  12. Bieri D, Reeve RA, Champion GD, Addicoat L, Ziegler JB. The Faces Pain Scale for the self-assessment of the severity of pain experienced by children: development, initial validation, and preliminary investigation for ratio scale properties. Pain 1990; 41: 139-50. https://doi.org/10.1016/0304-3959(90)90018-9
  13. Gedaly-Duff V, Ziebarth D. Mothers' management of adenoid-tonsillectomy pain in 4-to 8-year-olds: a preliminary study. Pain 1994; 57: 293-9. https://doi.org/10.1016/0304-3959(94)90004-3
  14. Vernon DT, Schulman JL, Foley JM. Changes in children's behavior after hospitalization. Some dimensions of response and their correlates. Am J Dis Child 1966; 111: 581-93. https://doi.org/10.1001/archpedi.1966.02090090053003
  15. Vernon DT, Thompson RH. Research on the effect of experimental interventions on children's behavior after hospitalization: a review and synthesis. J Dev Behav Pediatr 1993; 14: 36-44.
  16. Karling M, Stenlund H, Hagglof B. Child behaviour after anaesthesia: associated risk factors. Acta Paediatr 2007; 96: 740-7. https://doi.org/10.1111/j.1651-2227.2007.00258.x
  17. Kain ZN, Wang SM, Mayes LC, Caramico LA, Hofstadter MB. Distress during the induction of anesthesia and postoperative behavioral outcomes. Anesth Analg 1999; 88: 1042-7. https://doi.org/10.1213/00000539-199905000-00013
  18. Stargatt R, Davidson AJ, Huang GH, Czarnecki C, Gibson MA, Stewart SA, et al. A cohort study of the incidence and risk factors for negative behavior changes in children after general anesthesia. Paediatr Anaesth 2006; 16: 846-59.
  19. Yuki K, Daaboul DG. Postoperative maladaptive behavioral changes in children. Middle East J Anaesthesiol 2011; 21:183-9.
  20. Kain ZN, Mayes LC, Caldwell-Andrews AA, Karas DE, McClain BC. Preoperative anxiety, postoperative pain, and behavioral recovery in young children undergoing surgery. Pediatrics 2006; 118: 651-8. https://doi.org/10.1542/peds.2005-2920
  21. Kain ZN, Mayes LC, Wang SM, Hofstadter MB. Postoperative behavioral outcomes in children: effects of sedative premedication. Anesthesiology 1999; 90: 758-65. https://doi.org/10.1097/00000542-199903000-00018
  22. Watson AT, Visram A. Children's preoperative anxiety and postoperative behaviour. Paediatr Anaesth 2003; 13:188-204. https://doi.org/10.1046/j.1460-9592.2003.00848.x
  23. Lardner DR, Dick BD, Crawford S. The effects of parental presence in the postanesthetic care unit on children's postoperative behavior: a prospective, randomized, controlled study. Anesth Analg 2010; 110: 1102-8.
  24. Aguilera IM, Patel D, Meakin GH, Masterson J. Perioperative anxiety and postoperative behavioural disturbances in children undergoing intravenous or inhalation induction of anaesthesia. Paediatr Anaesth 2003; 13: 501-7. https://doi.org/10.1046/j.1460-9592.2003.01002.x
  25. Liu X, Guo C, Okawa M, Zhai J, Li Y, Uchiyama M, et al. Behavioral and emotional problems in Chinese children of divorced parents. J Am Acad Child Adolesc Psychiatry 2000; 39: 896-903. https://doi.org/10.1097/00004583-200007000-00019
  26. Weaver JM, Schofield TJ. Mediation and moderation of divorce effects on children's behavior problems. J Fam Psychol 2015; 29: 39-48. https://doi.org/10.1037/fam0000043
  27. Duru E, Poyrazli S. Personality dimensions, psychosocial demographic variables, and English language competency in predicting level of acculturative stress among Turkish international students. Int J Stress Manag 2007; 14:99-110. https://doi.org/10.1037/1072-5245.14.1.99
  28. Suarez-Morales L, Lopez B. The impact of acculturative stress and daily hassles on pre-adolescent psychological adjustment: examining anxiety symptoms. J Prim Prev 2009; 30: 335-49. https://doi.org/10.1007/s10935-009-0175-y
  29. Behnke AO, MacDermid SM, Coltrane SL, Parke RD, Duffy S, Widaman KF. Family cohesion in the lives of Mexican American and European American parents. J Marriage Fam 2008; 70: 1045-59. https://doi.org/10.1111/j.1741-3737.2008.00545.x
  30. Sam DL, Berry JW. Acculturation: when individuals and groups of different cultural backgrounds meet. Perspect Psychol Sci 2010; 5: 472-81. https://doi.org/10.1177/1745691610373075
  31. Leidy MS, Parke RD, Cladis M, Coltrane S, Duffy S. Positive marital quality, acculturative stress, and child outcomes among Mexican Americans. J Marriage Fam 2009; 71:833-47. https://doi.org/10.1111/j.1741-3737.2009.00638.x
  32. Karling M, Hagglof B. Child behaviour after anaesthesia:association of socioeconomic factors and child behaviour checklist to the Post-Hospital Behaviour Questionnaire. Acta Paediatr 2007; 96: 418-23. https://doi.org/10.1111/j.1651-2227.2007.00108.x
  33. Kain ZN, Mayes LC, O'Connor TZ, Cicchetti DV. Preoperative anxiety in children. Predictors and outcomes. Arch Pediatr Adolesc Med 1996; 150: 1238-45. https://doi.org/10.1001/archpedi.1996.02170370016002
  34. Kotiniemi LH, Ryhanen PT, Moilanen IK. Behavioural changes in children following day-case surgery: a 4-week follow-up of 551 children. Anaesthesia 1997; 52: 970-6. https://doi.org/10.1111/j.1365-2044.1997.202-az0337.x
  35. Eckenhoff JE. Relationship of anesthesia to postoperative personality changes in children. AMA Am J Dis Child 1953; 86: 587-91.
  36. Thompson RH, Vernon DT. Research on children's behavior after hospitalization: a review and synthesis. J Dev Behav Pediatr 1993; 14: 28-35.
  37. Fortier MA, Del-Rosario AM, Martin SR, Kain ZN. Perioperative anxiety in children. Paediatr Anaesth 2010; 20:318-22. https://doi.org/10.1111/j.1460-9592.2010.03263.x
  38. Kain ZN, Caldwell-Andrews AA, Maranets I, McClain B, Gaal D, Mayes LC, et al. Preoperative anxiety and emergence delirium and postoperative maladaptive behaviors. Anesth Analg 2004; 99: 1648-54.
  39. Kain ZN, Caramico LA, Mayes LC, Genevro JL, Bornstein MH, Hofstadter MB. Preoperative preparation programs in children: a comparative examination. Anesth Analg 1998; 87: 1249-55.
  40. Margolis JO, Ginsberg B, Dear GL, Ross AK, Goral JE, Bailey AG. Paediatric preoperative teaching: effects at induction and postoperatively. Paediatr Anaesth 1998; 8: 17-23. https://doi.org/10.1046/j.1460-9592.1998.00698.x
  41. Pederson C. Effect of imagery on children's pain and anxiety during cardiac catheterization. J Pediatr Nurs 1995; 10:365-74. https://doi.org/10.1016/S0882-5963(05)80034-X
  42. Bringuier S, Dadure C, Raux O, Dubois A, Picot MC, Capdevila X. The perioperative validity of the visual analog anxiety scale in children: a discriminant and useful instrument in routine clinical practice to optimize postoperative pain management. Anesth Analg 2009; 109: 737-44. https://doi.org/10.1213/ane.0b013e3181af00e4
  43. Ericsson E, Wadsby M, Hultcrantz E. Pre-surgical child behavior ratings and pain management after two different techniques of tonsil surgery. Int J Pediatr Otorhinolaryngol 2006; 70: 1749-58. https://doi.org/10.1016/j.ijporl.2006.05.017
  44. Palermo TM, Drotar D. Prediction of children's postoperative pain: the role of presurgical expectations and anticipatory emotions. J Pediatr Psychol 1996; 21: 683-98. https://doi.org/10.1093/jpepsy/21.5.683
  45. Logan DE, Rose JB. Is postoperative pain a self-fulfilling prophecy? Expectancy effects on postoperative pain and patient-controlled analgesia use among adolescent surgical patients. J Pediatr Psychol 2005; 30: 187-96. https://doi.org/10.1093/jpepsy/jsi006
  46. Crandall M, Lammers C, Senders C, Braun JV. Children's tonsillectomy experiences: influencing factors. J Child Health Care 2009; 13: 308-21. https://doi.org/10.1177/1367493509344821
  47. Elemen L, Seyidov TH, Tugay M. The advantages of cyanoacrylate wound closure in circumcision. Pediatr Surg Int 2011; 27: 879-83. https://doi.org/10.1007/s00383-010-2741-z

피인용 문헌

  1. Behavioral Changes in Children After Emergency Department Procedural Sedation pp.10696563, 2017, https://doi.org/10.1111/acem.13332
  2. Severe acute postoperative pain self-reported by children after ambulatory surgeries: a cohort study vol.74, pp.4, 2021, https://doi.org/10.1590/0034-7167-2020-0151
  3. Mothers Level of Education and Preoperative Informative Story Book Reading Helps Reduce Preoperative Anxiety in Children in Turkey vol.60, pp.None, 2015, https://doi.org/10.1016/j.pedn.2021.02.012