Summary:
OBJECTIVES. In this study we evaluated the postoperative anxiety and pain in
children who were operated on for phimosis. Furtheromore, our specific aims
were to identify risk factors associated with postoperative pain and anxiety.
SUBJECTS AND METHODS. Boys, ASA I-II, with phimosis were included in the study.
Circumcision was performed with one of the following techniques: sutureless
prepuceplasty, preputial plasty, and conventional circumcision. Analgesia
during operation was performed either with paracetamol or regional block plus
paracetamol. The evaluation of postoperative pain was performed with the FLACC
scale (Face, Legs, Activity, Cry, Consolability) and FACES scale, in
conjunction with a visual analogue scale. At home, the presence of
postoperative anxiety was assessed by parents, based on the presence of
behavioral changes. The following factors were taken into account for posible
influence in the presence of postoperative pain and anxiety: the age of
patients, the social and educational level of parents, previous distressing
experience, the preoperative preparation, the presence of additional siblings
in the family, postoperative complications and nationality.
Statistics. The SPSS 16.0 software program was used for statistical analysis.
Chi-squared, t-test and annova were performed for analysis of the variables.
The use of a multivariate logistic regression analysis was used to analyse the
impact of the above mentioned factors. A p value <0.05 was considered as
statistical significant
RESULTS. A total of 301 patients (aged 2-14 years) were enrolled in the study.
Congenital phimosis had 285/301 (94.7%) patients και acquired 16 (5.3%).
Conventional circumcision underwent 109 (36.2%) boys, sutureless prepuceplasty
underwent 93 (30.9%) and preputial plasty was performed in 99 (32.9%) boys.
The multivariate logistic regression analysis showed that there is a
statistical significant correlation between postoperative pain and boys who
underwent conventional circumcision or preputial plasty, and boys who had
postoperative complications. Concerning the postoperative anxiety, a
statistical correlation among postoperative anxiety and boys without siblings,
those who are foreigners, and boys with previous unpleasant experience (p:
0.016, p: 0.002, respectively) was noticed.
CONCLUSIONS. This study showed that the surgical technique and the presence of
postoperative complications are among factors that may cause postoperative pain
in boys who were operated on for phimosis. Regarding the postoperative anxiety,
foreigners and children without siblings may develop maladaptive behavioral
changes.
Key words: children, phimosis, postoperative pain, postoperative anxiety
Keywords:
Children, Phimosis, Postoperative pain, Postoperative anxiety
