Pre-op Anxiety May Predict Post-op Delirium

Author: Ethan Covey

Anesthesiology News

Preoperative anxiety, measured using the modified Yale Preoperative Anxiety Scale (mYPAS), can predict rates of emergence delirium, according to a new study.

“This study is important because early identification of these at-risk patients can alert the anesthesiologist to appropriately and preemptively medicate patients,” said Ali Atoot, a fourth-year medical student at St. George’s University in Grenada, West Indies, and the lead author of the study. “The physician anesthesiologist can initiate meaningful conversation with family regarding the postoperative course, adding to family satisfaction and well-being of the patient.”

Emergence delirium refers to a variety of behavioral disturbances commonly seen in children following emergence from anesthesia. It is considered a complex of perceptual disturbances and psychomotor agitation that increase the risk for self-injury and delayed discharge, and requires additional medical staff attention and potentially increased health care costs. Mr. Atoot and his colleagues sought to investigate the role of preoperative anxiety scales in anticipating the development of emergence delirium.

“By identifying these patients as soon as possible, we hope to decrease the risk of postoperative delirium,” Mr. Atoot said. “Prompt and easy identification of emergence delirium is beneficial for both family and perioperative staff.”

Additionally, now that this correlation has been shown, Mr. Atoot expressed his interest in further studying what medications and other modalities are best for reducing postoperative delirium.

Stavros G. Memtsoudis, MD, PhD, a clinical professor of anesthesiology at Weill Cornell Medical College, and an anesthesiologist at the Hospital for Special Surgery, in New York City, said the data are important proof that the link between baseline psychological disturbances and postoperative delirium seen in adults also exists in children. It also presents opportunities to research other anxiety-related links.

“It would be interesting to see if the authors can expand their research to investigate the association of anxiety and postoperative pain,” Dr. Memtsoudis said. “I would not be surprised if it did.”