Study of the prophylaxis of psychological responses to ENT procedures

Background: Negative psychological responses are adverse factors of the surgical experience. Non-pharmacological strategies, such as psychoprophylaxis to mitigate preoperative anxiety in children, are perhaps the most important. Objective: The detection and mitigation of preoperative anxiety in the pediatric patient using a three-step strategy over a period of one month to obtain better results in the postoperative period. Materials and Methods: Descriptive study of pediatric patients aged 5–12 years who underwent scheduled ear, nose, and throat surgery at UMAE H.E. 14 CMN Adolfo Ruiz Cortines at Veracruz, Mexico, and randomly divided into the pediatric surgical psychoprophylaxis (PSP) group = to which the PSP process was applied, which comprised three sessions over a period of approximately 4 weeks, and the control group (CG) = children who received conventional anesthetic information. They were assessed with the state-trait anxiety inventory for children (STAIC) inventory to measure their anxiety at two moments, in the surgical scheduling consultation (SC), after signing the informed consent form, as well as in the operating room (OR), before their operation; and the Yale Preoperative Anxiety Scale-modified (YPAS-m) in the OR. The CG was only given information about the aspects of the surgery, routine in the SC, and on the day of the operation, in the OR, the two inventories, STAIC and YPAS-m, were applied. Results: Thirty-six patients were included, with a mean age of 8.2 years, 63.9% ( N = 23) males. There was a statistically significant difference in anxiety levels between the STAIC of the SC and OR of the PSP group, as well as in OR between the two groups with STAIC and YPAS-m. Anxiety was significantly higher in children who did not receive PSP (STAIC score; Student t test, P = 0.0057). The YPAS-m score showed that only 38.9% ( N = 7) of patients in the PSP group were anxious, compared to all patients in the CG. Conclusions: The quality of preoperative information is important, but a period of time that allows the child’s brain to cope with the surgical process is more important; the prevalence of anxiety was low at the SC time, increasing significantly at the OR time. The quality of the “conventional information + brochures” (CIB) was superior to the verbal “conventional information” (CI) if it was given well before the operation.