PREOPERATIVE PREPARATION PROGRAMS IN CHILDREN - A COMPARATIVE-EXAMINATION

We sought to determine whether an extensive behavioral preparation pro gram for children undergoing surgery is more effective than a Limited behavioral program. The primary end point was child and parent anxiety during the preoperative period. Secondary end points included behavio r of the child during the induction of anesthesia and the postoperativ e recovery period. Several days before surgery, children (n = 75) aged 2-12 yr randomly received either an information-based program (OR tou r), an information + modeling-based program (OR tour + videotape), or an information + modeling + coping-based program (OR tour + videotape + child-life preparation). Using behavioral and physiological measures of anxiety, we found that children who received the extensive program exhibited less anxiety immediately after the intervention, in the hol ding area on the day of surgery, and on separation to the operating ro om. These findings, however, achieved statistical significance only in the holding area on the day of surgery (44[10-72] vs 32[8-50] vs 9[6- 33]; P = 0.02). Similarly, parents in the extensive program were signi ficantly less anxious on the day of surgery in the preoperative holdin g area, as assessed by behavioral (P = 0.015) and physiological measur es (P = 0.01). In contrast, no differences were found among the groups during the induction of anesthesia, recovery room period, or 2 wk pos toperatively. We conclude that children and parents who received the e xtensive preoperative preparation program exhibited lower levels of an xiety during the preoperative period, but not during the intraoperativ e or postoperative periods. Implications: The extensive behavioral pre operative program that we undertook had limited anxiolytic effects. Th ese effects were localized to the preoperative period and did not exte nded to the induction of anesthesia or the postoperative recovery peri od.