The intermediate effect of pre-surgery anxiety on the relationship between acute post-operative pain and nause-vomiting in children

This study examines the mediating effect of preoperative anxiety on the relationship between acute pain and nausea-vomiting seen after surgery in children. Preoperative anxiety, postoperative pain and nausea-vomiting levels were measured and the relationships between them were analyzed. In this study, FLAAC Pain Scale, modified Yale Preoperative Anxiety Scale and Barf Nausea Scale Score were used to evaluate pain, anxiety and postoperative nausea respectively. The statistical analysis of our study was performed using SPSS version 25.0 program. Shapiro-Wilk test was used to evaluate the normal distribution of variables. Descriptive analysis used mean and standard deviation values for presentation purposes. In addition, independent two-sample t-Test was used to evaluate normally distributed variables between multiple groups. A total of 77 patients were included in the study. The mean age of the patients was 9.84±2.52 years and 74.03% were male. 24.68% of the children were attending second grade. The mean body weight of the children was 30.78±9.88 kg, and their height was 132.19±10.92 cm. 37.66% of the children had undergone surgery before and 46.75% had been hospitalized before. The mean hospitalization time was 3.37±3.58. The findings obtained showed that preoperative anxiety had both direct and indirect effects on both pain and nausea-vomiting. Postoperative pain and nausea-vomiting severity were higher in children with high preoperative anxiety levels. In addition, it was found that part of the effect of preoperative anxiety on postoperative pain was mediated by nausea-vomiting. These results show that preoperative anxiety plays an important role in the prevention and treatment of postoperative pain and nausea-vomiting in children.