Anxiety and postoperative pain in children who undergo major orthopedic surgery

Anxiety and pain are major concerns not only for children who undergo surge ry, but also for their parents and health care professionals. A convenience sample of 74 adolescents who underwent major orthopedic surgery for repair of idiopathic scoliosis and their parents was used to investigate the rela tionships among children's and parents' preoperative and postoperative anxi ety and children's postoperative pain. Age-appropriate versions of Spielber ger's State-Anxiety scales measured children's and parents' anxiety, and a visual analog scale assessed children's pain intensities. Children's state anxiety increased from preoperative to postoperative levels, and their post operative anxiety levels positively related to their pain intensities on da ys 2 and 4 following the operation. Parents' anxiety decreased from preoper ative to postoperative levels, and their postoperative anxiety positively r elated to their children's postoperative anxiety. Studying both parents and children helped to explain the variance in children's self-reported anxiet y. Parents' emotional states are important indicators of children's emotion al states and, subsequently, their pain experience. The results of this stu dy suggest that allowing children to assist in the assessment of their post operative pain may help health care professionals better understand the sub jective component of pain. The findings also emphasize the importance of in cluding parents in future studies in which the aim is to understand childre n's behavioral responses and recovery outcomes. Copyright (C) 2001 by W.B. Saunders Company.