Children who are very anxious before an operation have a more difficult recovery after surgery, a new study shows.

“We just can’t ignore anxiety and pain in children before and after surgery,” Dr. Zeev N. Kain of Yale University School of Medicine in New Haven, Connecticut, the study’s lead author, told Reuters Health.

While programs designed to prepare children for surgery can help make the process less scary for kids and their parents, they are being offered less and less frequently due to economic pressures, Kain noted.

Past studies in adults have found that while being a little anxious before surgery can make for a better recovery, too much anxiety actually worsens recovery, Kain and his team point in the medical journal Pediatrics. The question of how anxiety affects young children’s recovery after surgery had never been addressed.

To investigate, the researchers followed 241 children 5 to 12 years old who were undergoing outpatient tonsillectomy and adenoidectomy. Forty-four of the children were classified as high-anxiety, while the remaining 197 were low anxiety.

High anxiety children experienced significantly more pain and needed more painkillers in the hospital after surgery and for the first three days at home, the researchers found. While just 1.5 percent of low-anxiety children emerged from anesthesia in a very agitated state - which is known as emergence delirium - 9.7 percent of children in the high-anxiety group did.

At home, the high-anxiety children also had more difficulty sleeping and were more likely to wake up crying.

However, most of the differences between the two groups had disappeared by three days after surgery.

The study underscores the importance of preparing children for the experience of having surgery, Kain said. “Generally speaking, children should know that they are coming to have surgery,” he added. “You would be amazed at the number of children who show up and they don’t know why they’re here.”

This preparation can be very simple, Kain advised. “You need to prepare your child for the experience, you need to talk with your child about the process in a language that the child will understand.”

And the more parents themselves are able to relax, the better for their children, he added. “There is a very, very strong correlation between parents’ anxiety and children’s anxiety.”

SOURCE: Pediatrics, August 2006.