Effective psychological and/or pharmacological preparation for elective pediatric surgery can reduce stress

Eighty children undergoing morning-session elective herniorrhaphy or orchidopexy were divided into two groups according to age (3–51/2 years and 57/12–12 years). Each group was again subdivided according to the presence or absence of either psychological or “pharmacological” preparation (the child falls asleep in the arms of the mother), yielding four subgroups: (1) psychological (Ps +); (2) pharmacological (Ph +); (3) (Ps + Ph +); and (4) (Ps−Ph−). At the beginning of anesthesia blood was drawn for cortisol level measurement. One month after surgery the children's adjustment scores were evaluated statistically. The cortisol level of the younger age group was lower than that of the older age group (P < 0.01) and that of children who received “parmacological” preparation was lower than in those who did not (P < 0.05). Concerning posthospital behavioral disturbances: the older age group benefited more from psychological preparation (Ps +), and its absence was detrimental to the mental health of this population (P < 0.05). The younger age group benefited more from induction of anesthesia in the presence of parents (Ph +), and its absence entailed risks to their mental health (P < 0.05).