Could the ratio of the second finger to the fourth finger (2D:4D) be a new morphological marker in predicting preoperative anxiety and postoperative agitation in pediatric patients?

Abstract

Studies have reported that the ratio of the second finger to the fourth finger (2D:4D) indicating the effects of intrauterine andogene exposure. It is stated that it can be used as a morphological marker in evaluating developmental/ psychopathological disorders. 90 children between the ages of 5-10, who were planned to undergo deciduous tooth extraction under deep sedation, were included in the study. Measurements were made on the second and fourth fingers of children's right and left hands. The behaviors of the patients during the preoperative period (m-Yale Preoperative Anxiety Scale), vascular access insertion and separation from the family were evaluated in determining the anxiety levels of the patients. During the recovery process, agitation status was evaluated using Watcha Scale. And there was no significant relationship found between 2D:4D and these parameters. In conclusion, 2D:4D did not succeed as a morphological marker in predicting preoperative anxiety and postoperative agitation in the preoperative period.

Keywords

• Preoperative anxiety
• postoperative agitation
• 2D:4D

References

1. West, N., Christopher, N., Stratton, K., Görges, M., Brown, Z., 2020. Reducing preoperative anxiety with Child Life preparation prior to intravenous induction of anesthesia: A randomized controlled trial. Paediatr. Anaesth. 30, 168-180
2. Meletti, D.P., Meletti, J.F.A., Camargo, R.P.S., Silva, L.M., Módolo, N.S.P. 2019. Psychological preparation reduces preoperative anxiety in children. Randomized and double-blind trial. J. Pediatr. 95, 545-551.
3. Dixit, U.B., Jasani, R.R., 2020. Comparison of the effectiveness of Bach flower therapy and music therapy on dental anxiety in pediatric patients: A randomized controlled study. J. Indian. Soc. Pedod. Prev. Dent. 3, 71-78.
4. Dwairej, D.A., Obeidat, H.M., Aloweidi, A.S., 2020. Video game distraction and anesthesia mask practice reduces children's preoperative anxiety: A randomized clinical trial. J. Spec. Pediatr. Nurs. 25, e12272.
5. Hino, M., Mihara, T., Miyazaki, S., Hijikata, T., Miwa, T., Goto, T.,Ka, K., 2017. Development and Validation of a Risk Scale for Emergence Agitation After General Anesthesia in Children: A Prospective Observational Study. Anesth. Analg. 125, 550-555.
6. Ali, I., Alahdal, M., Xia, H., S El Moughrabi, A., Shiqian, H., Yao, S., 2020. Ketofol performance to reduce postoperative emergence agitation in children undergoing adenotonsillectomy. Libyan. J. Med. 15, 1688450.
7. Richards, G., 2017. What is the evidence for a link between digit ratio (2D:4D) and direct measures of prenatal sex hormones? Early. Hum. Dev. 113, 71-72.
8. Eichler, A., Heinrich, H., Moll, G.H., Beckmann, M.W., Goecke, T.W., Fasching, P.A., Muschler, M.R., Bouna-Pyrrou, P., Lenz, B., Kornhuber, J., 2018. Digit ratio (2D:4D) and behavioral symptoms in primary-school aged boys. Early. Hum. Dev. 119, 1-7.

9. Myers, L., Van't Westeinde, A., Kuja-Halkola, R., Tammimies, K., Bölte, S., 2018. 2D:4D Ratio in Neurodevelopmental Disorders: A Twin Study. J. Autism. Dev. Disord. 48, 3244-3252.
10. Ribeiro, E. Jr., Neave, N., Morais, R.N., Kilduff, L., Taylor, S.R., Butovskaya, M., Fink, B., Manning, J.T., 2016.. Digit ratio (2D:4D), testosterone, cortisol, aggression, personality and hand-grip strength: Evidence for prenatal effects on strength. Early. Hum. Dev. 100, 21-5.
11. Togo, S., Itahashi, T., Hashimoto, R., Cai, C., Kanai, C., Kato, N., Imamizu, H., 2019. Fourth finger dependence of high-functioning autism spectrum disorder in multi-digit force coordination. Sci. Rep. 9, 1737.
12. Butovskaya, M., Burkova, V., Karelin, D., Filatova, V., 2019. The association between 2D:4D ratio and aggression in children and adolescents: Cross-cultural and gender differences. Early. Hum. Dev. 137, 104823.
13. O'Briain, D.E., Dawson, P.H., Kelly, J.C., Connolly, P., 2017. Assessment of the 2D:4D ratio in aggression-related injuries in children attending a paediatric emergency department. Ir. J. Med. Sci. 186, 441-445.
14. Malik, R., Yaddanpudi, S., Panda, N.B., Kohli, A., Mathew, P.J., 2018. Predictors of Pre-operative Anxiety in Indian Children. Indian. J. Pediatr. 85, 504-509.
15. Moura, L.A., Dias, I.M., Pereira, L.V., 2016. Prevalence and factors associated with preoperative anxiety in children aged 5-12 years. Rev. Lat. Am. Enfermagem. 24, e2708.
16. Devroe, S., Devriese, L., Debuck, F., Fieuws, S., Cools, B., Gewillig, M., Van de Velde, M., Rex, S., 2020. Effect of xenon and dexmedetomidine as adjuncts for general anesthesia on postoperative emergence delirium after elective cardiac catheterization in children: study protocol for a randomized, controlled, pilot trial. Trials. 21, 310.
17. Referans17 Cho, E.A., Cha, Y.B., Shim, J.G., Ahn, J.H., Lee, S.H., Ryu, K.H., 2020. Comparison of single minimum dose administration of dexmedetomidine and midazolam for prevention of emergence delirium in children: a randomized controlled trial. J. Anesth. 34, 59-65.
18. Lenz, B., Thiem, D., Bouna-Pyrrou, P., Mühle, C., Stoessel, C., Betz, P., Kornhuber, J., 2016. Low digit ratio (2D:4D) in male suicide victims. J. Neural. Transm. (Vienna) 123, 1499-1503.
19. Hilgard, J., Engelhardt, C.R., Rouder, J.N., Segert, I.L., Bartholow, B.D., 2019. Null Effects of Game Violence, Game Difficulty, and 2D:4D Digit Ratio on Aggressive Behavior. Psychol. Sci. 30, 606-616.
20. Lerman, J., 2018. Does the Risk Scale Predict Emergence Agitation in Children? Anesth, Analg, 126, 365.
21. Berghmans, J.M., Poley, M., Weber, F., Van De Velde, M., Adriaenssens, P., Klein, J., Himpe, D., Utens, E., 2015. Does the Child Behavior Checklist predict levels of preoperative anxiety at anesthetic induction and postoperative emergence delirium? A prospective cohort study. Minerva. Anestesiol. 81, 145-56.