The epidemiology and selective identification of children at risk for preoperative anxiety reactions.

This observational outpatient study was undertaken prospectively to assess the effect of age and gender on the frequency of children's difficulty with preoperative parental separation and to examine five simple clinical factors as predictors of problematic preoperative behavior. Although gender had no significant effect, 2- to 6-yr-old children were more likely than children 7 to 8 yr old to exhibit problematic behavior on parental separation (P < 0.05). In 2- to 6-yr-old children, three factors were significant predictors of problematic behavior: not taking a preoperative family tour (P < 0.05), having undergone previous surgery (P < 0.05), and preoperatively displaying a dependent or withdrawn affect (P < 0.05). Instead of implementing the routine use of a sedative, optimal management seems to involve sedating only 2- to 6-yr-old children who display one or more of these significant predictive risk factors.