Making surgery less scary for kids

Surgery can be traumatic for children – and their parents. But it doesn’t have to be.

To guide families through the experience, Dr. Zeev Kain, chair of UC Irvine’s Department of Anesthesiology & Perioperative Care, is partnering with DMA Animation — a studio that has produced content for MTV and online games for Nickelodeon.

Funded with a two-year, $1.7 million National Institutes of Health grant, Kain’s team will create and implement a unique Internet site to help parents ease children’s anxiety (and their own), properly manage postsurgical pain and, ultimately, facilitate healing.

The Web-based Tailored Intervention Preparation for Surgery (WebTIPS) site will address one of the most pressing needs in pediatric surgical care. About 60 percent of the 5 million children who undergo surgery in the U.S. each year develop extreme anxiety beforehand and suffer from unnecessary pain afterward.

“Not only are anxiety and pain emotionally traumatic, but recent data indicates that high anxiety actually heightens postsurgical pain and can affect recovery,” Kain says.

Changing medical practices compound the problem. A growing number of surgeries performed on children – up to 90 percent – are outpatient procedures. This means parents must deal with the bulk of postoperative anxiety and pain and they may not be adequately prepared to handle the task.

“With a significant majority of pediatric surgeries done on an outpatient basis, anesthesiologists are losing opportunities to prepare families for recovery,” he says. “In many cases, postsurgery pain is not properly managed. A lot of kids are undermedicated after they return home.”

The interactive WebTIPS site will provide detailed information for parents about surgical procedures and postoperative pain management. It will also develop a personalized plan for alleviating anxiety and pain, taking into account other medical and psychological factors, such as the parents’ coping and caring skills.

To utilize the service, parents will log into the site at least five days before surgery and fill out a questionnaire, including parents’  attitudes toward pain and their own anxiety over the surgery.

“The result will be a program specifically tailored to the child’s needs and the parents’ ability to provide care,” says Kain, who is also associate dean for clinical research at UCI. “We want to provide the guidance for families to manage their children’s surgeries.”

WebTIPS will also feature individualized, downloadable podcasts and a 24-hour call-in service should parents need more assistance.

Kain created the site’s content, which will be integrated into a prototype Web format ready for use in 18 months. Once tested, the site will be made available to all hospitals and surgical centers.

“What’s wonderful about WebTIPS is that it will have a very large impact,” Kain says. “All families will need is access to the site. It’s our belief that WebTIPS can help empower families to make surgery less stressful for their children and improve their recovery.”