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  • Title: [Effect of prior operations on fear of anesthesia and surgery in young children].
    Author: Breitkopf L, Büttner W.
    Journal: Anaesthesist; 1986 Jan; 35(1):30-5. PubMed ID: 3963350.
    Abstract:
    From the standpoint of behavior therapists three different prognoses are possible for the behavior of preschool-children with prior operations when they undergo a new operation: 1. The pain of the prior operation has led to classical conditioned surgical phobias (conditioning paradigm); 2. during prior operations the pain was suppressed by anaesthetics, therefore a classical conditioning of surgical phobias cannot have happened, and as a consequence the behavior before a new operation is not predictable; 3. prior operations have led to habituation and extinction of phobias (habituation paradigm). By comparing two groups of children all aged between 2 and 6 years, one group with at least one prior operation, the other undergoing the first operation in their lives, an empirical decision between the proposals is sought. N = 66 children (none with an acute indication for surgery) were observed immediately before premedication and again immediately before anaesthetization; the anxiety of the children was scaled on 8 rating-scales. Posthoc the children were classified as prior operated or first operated according to their medical history. Statistical analysis of the data reveals that children with prior operations in their lives behave significantly more anxiously immediately before premedication compared with first operated children. After premedication immediately before anaesthesia the difference between the two groups is at random. The authors conclude that prior operations must have been associated with pain, which led to the conditioning of surgical phobias; they cannot exclude the possibility that conditioning could have happened both before and after surgery. Implications for post-surgery-care are discussed.
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