Key result
Preassessment linked to ~27% less perioperative anxiety in children without affecting overall cancelation rates.
Why the study?
Pediatric preassessment is recommended before general anesthesia to potentially improve safety and quality outcomes, but its delivery format and impact on outcomes needed evaluation.
Does preassessment before general anesthesia reduce on-the-day cancelation and patient anxiety in children undergoing elective procedures?
Does preassessment before general anesthesia reduce on-the-day cancelation and patient anxiety in children undergoing elective procedures?
Preassessment before pediatric general anesthesia significantly reduces perioperative anxiety but does not significantly affect overall cancelation rates.
Background Pediatric preassessment is recommended for all children undergoing general anesthesia. It has the potential to improve safety and quality outcomes for both the patient and the organization. Aims This study aimed to establish the proportion of children who underwent preassessment before general anesthesia, the format of that preassessment, and the impact of preassessment on outcomes such as on‐the‐day cancelation, and patient anxiety. Methods This multi‐center prospective observational cohort study outlines preassessment delivery in the UK and its effect on outcome. Invitation to participate was via Pediatric Anesthetic Trainee Research Network. Data collected included demographic data, details of the patient's preassessment, and their outcome. Results Data were verified from 96 hospitals on 6818 patients between 1 and 16 years old having elective procedures under general anesthetic. The proportion of children ≤ 16 years old who received preassessment was 60.1% (4082 children). There was a large variation in the delivery of preassessment with the majority being nurse‐led. The perioperative journey of most children proceeded as planned (6454 patients, 94.6% of cases). There was a significant difference in the proportion of children with perioperative anxiety between those who did (12.0%, n = 482) and did not (16.5%, n = 438) have a preassessment ( p < 0.001). Preassessment did not make a statistically significant difference to overall cancelation rates. The most common reasons for cancelation were intercurrent illness and anxiety. A greater proportion of procedures were delayed or canceled if anxiety was identified as a perioperative challenge: 20.8% ( n = 191) compared to 3.6% ( n = 210, p < 0.001). Conclusion These data suggest that improved outcomes could be achieved through a reduction in anxiety. A service offering screening calls in the days before surgery could prevent on‐the‐day cancelation due to intercurrent illness. The priorities for preassessment in children require further clarification and standardization nationally to maximize the potential benefits from services.
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Bennett et al. (2026) studied this question. Preassessment significantly reduced perioperative anxiety in children (12.0% with preassessment vs 16.5% without, p < 0.001) but did not affect overall cancelation rates.
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