Treatment Before Surgery Reduces Anxiety in Both Mother and Child
By Editorial Staff
It's natural for parents to be nervous when their child is about to undergo surgery. Children often pick up on the increased levels of stress and anxiety expressed by their parents, however.
This situation usually increases the child's own anxiety level which, in turn, can have a negative effect on the child's behavior and recovery once the surgical procedure is over. It can also be a measure of concern for the physician preparing the child for surgery.
Acupuncture has long been known as an effective method of relieving stress and anxiety; dozens of clinical studies have attested to its efficacy in this area. What hadn't been studied until just recently, however, was the effect acupuncture could have in relieving anxiety in parents before their children were wheeled into the operating room. In a study presented at the most recent annual meeting of the American Society of Anesthesiologists (ASA),1 scientists determined that small needles placed on strategic points of a mother's ear can significantly decrease anxiety levels not only in the mother, but also her child, during the critical stages leading up to surgery.
Dr. Shu-Ming Wang, an anesthesiologist at the Yale University School of Medicine, led the three-year study. In an interview with Newswise Medical News, Dr. Wang related the details of some of her experiences with anxious parents, which helped explain the importance of the study.
"I personally have witnessed crying parents enter a child's operating room, which invariably causes the child to cry and affect the procedure," Wang said. "All this anxiety distracts health care providers' attention away from the most important person in the procedure: the child."2
Wang's study involved 66 mothers whose children were about to undergo surgery. The mothers were assigned randomly to an intervention group or a sham control group. Mothers in the intervention group were treated with small acupuncture needles called auricular press needles, inserted at "relaxation, valium and master cerebral points" on the ear. The control group was treated with press needles at the shoulder, wrist and an extraneous auricular point. The acupuncture was performed approximately 30 minutes prior to induction of anesthesia.
"After the insertion of needles into the auricular, most of them were pleasantly surprised and asked, 'Is that it?'" Dr. Wang said. "Many of the patients laughed after I showed them the press needles, and only a handful of them experienced a slight stinging sensation."
After receiving acupuncture, the mothers and children remained in a holding room until the anesthesia was administered. None of the children received any sedative premedication, and all of the mothers were remained with their children while the anesthesia was administered. Wang and her team of researchers measured the anxiety level of each child (on a scale of 0-100) during induction of anesthesia, and the mothers' anxiety, blood pressure and heart rate after the induction of anesthesia.
Following the introduction of anesthesia, the anxiety level of mothers treated with acupuncture was "significantly lower" compared to that of mothers in the control group. Moreover, children whose mothers received ear acupuncture were demonstrably less anxious upon entrance to the operating room, and when the anesthesia mask was introduced.
One of the more interesting findings from the research was that at the end of the study, but while participants were still blinded as to which group they were in, the researchers noted that "significantly more mothers" in the treatment group requested to keep the press needles in place (51.4 percent) compared to those in the control group (9.7 percent).
"To our surprise, in the interventional group, more mothers said, 'We'd like to keep the needles in if we can,'" Wang observed.3
Dr. Wang stressed that while reducing anxiety levels in parents is beneficial in and of itself, the person who benefits most from having a relaxed parent is the child. Previous studies published in the Archives of Pediatric and Adolescent Medicine and elsewhere have shown that children of anxious parents are more likely after surgery to cling to their parents, have nightmares, wet their beds and act aggressively, than children of less anxious parents.4-6
"Usually, high-anxiety parents have high-anxiety kids," she said.7
Although the exact mechanism by which acupuncture works remains unclear, Wang believed that the results of her research proved what hundreds of other studies have already shown - that acupuncture does work, especially in conjunction with certain forms of Western medicine.
"I do not believe that acupuncture is for all illnesses and symptoms, but I strongly believe that if we can combine the best of acupuncture with the best of allopathic medicine, we will achieve the best care for our patients," Dr. Wang said.
The abstract documenting Dr. Wang's research is available for free at the ASA's abstracts Web site (see reference #1). Acupuncturists and doctors of Oriental medicine are encouraged to view the abstract and share this information with their patients, along with the appropriate health care professionals.
Wang SM, Weinberg ME, Caldwell-Andrews AA, et al. Auricular acupuncture: a new treatment modality for parental preoperative anxiety. Abstract #A-1431. Presented at the American Society of Anesthesiologists 2003 annual meeting, Oct. 15, 2003. Available online at www.asa-abstracts.com.
Mothers get an earful of relief from acupuncture during kids' surgery. Newswise Medical News, Oct. 15, 2003.
Kain ZN, Mayes LC, O'Connor TZ, et al. Preoperative anxiety in children. Predictors and outcomes. Archives of Pediatric and Adolescent Medicine Dec. 1996;150:1238-1245.
Kain ZN, McCann ME. The management of preoperative anxiety in children: an update. Anesthesia & Anelgesia 2001;93:98-105.
Kain ZN, Wang SM, Mayes LC, et al. Distress during the induction of anesthesia and postoperative behavioral outcomes. Anesthesia & Analgesia 1999;88:1042-1047.
Vital signs. Treating parents helps ease child's worries. San Jose Mercury News, Oct. 21, 2003.
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