Association of preoperative anxiety level and postoperative pain in children undergoing general anesthesia of oral and maxillofacial day surgery

doi:10.19438/j.cjoms.2025.02.008

Abstract

Abstract: PURPOSE: To explore the association between preoperative anxiety levels and postoperative pain in children undergoing general anesthesia of oral and maxillofacial day surgery. METHOD: A total of 769 children aged 3-12 years undergoing general anesthesia of oral and maxillofacial day surgery were included. According to the postoperative FLACC Pain Assessment Scale score, the children were divided into a postoperative pain group (FLACC≥ 4) and a non-pain group (FLACC< 4). Univariate and multivariate regression analyses were conducted on demographic data, preoperative anxiety levels of the children and their parents, surgical type, perioperative anesthetics and analgesics between the groups to explore the association of preoperative anxiety levels and postoperative pain in these children. R 4.2.3 software package was used for data analysis. RESULTS: The incidence of postoperative pain in children under general anesthesia of oral and maxillofacial day surgery was 25.88%. Univariate regression suggested the preoperative Modified Yale Preoperative Anxiety Inventory(mYPAS) in pediatric patients (OR=3.31, 95%CI: 2.15-5.15, P< 0.001) and preoperative State Anxiety Inventory (SAI) score in parents (OR=2.04, 95%CI: 1.14-3.69, P=0.017) were associated with an increased risk of postoperative pain. After further adjusting for age, gender, BMI, medical history, fentanyl dosage, sufentanil dosage, ketamine dosage, and anesthesia duration, multiple regression analysis showed that higher mYPAS(OR=2.04, 95%CI: 1.27-3.3, P=0.003) in pediatric patients was associated with an increased risk of postoperative pain. There was no significant correlation between parental preoperative Trait Anxiety Inventory (TAI) score and the increased risk of postoperative pain in children. Subgroup analysis results showed that increased mYPAS scores in children without medical or surgery history, as well as increased SAI in parents who underwent plastic surgery or with surgery histories of their children, were associated with the higher risk of postoperative pain. The interaction between preoperative mYPAS and parental SAI-TAI on postoperative pain only showed a trend significance and did not show statistical differences. CONCLUSIONS: Preoperative anxiety levels in children and the parental state anxiety were association with high risk of postoperative pain in children undergoing oral and maxillofacial day surgery. Therefore, effective interventions to reduce preoperative anxiety may improve postoperative pain management in this pediatric population.

Key words: General anesthesia, Pediatric, Preoperative anxiety, Postoperative pain, Oral and maxillofacial day surgery

CLC Number:

R782.05

SHEN Xiao-min, ZHONG Lin-hong, LI Jing-jie, LIU Jin-xing, QIU Lin. Association of preoperative anxiety level and postoperative pain in children undergoing general anesthesia of oral and maxillofacial day surgery[J]. China Journal of Oral and Maxillofacial Surgery, 2025, 23(2): 152-158.

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