Impact of parental presence during induction of anesthesia on anxiety level among pediatric patients and their parents: a randomized clinical trial

Sadeghi, Amir; Tabari, Ahmad Khaleghnejad; Mahdavi, Alireza; Salarian, Sara; Razavi, Seyed Sajjad

doi:10.2147/ndt.s119208

Cited by 52 publications

(43 citation statements)

References 15 publications

(23 reference statements)

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“…Moreover, the anxiety of the children increased as they advance through the preoperative stages towards the operating theatre, with separation from the parents being the moment at which most patients experienced PAO, even though the moment of anaesthetic induction is that at which the anxiety score is highest. Earlier studies have also indicted that the moment of anaesthetic induction as that at which anxiety is maximal 4,14,22 . The discrepancy between the time points with the maximum PAO scores and the highest proportion anxiety patients in our study can be explained by the fact that the parents are separated from their children when they enter the operating theatre, while in many of the studies reviewed the parents remain with their children until the moment of anaesthetic induction 4,5,[iv] .…”

Section: Discussionmentioning

confidence: 99%

Comparation Of Different Scales To Assess Preoperative Anxiety In Children And Adolescent Undergoing Major Outpatient Surgery

Vieco-García¹,

Picado²,

Joyanes³

et al. 2020

Preprint

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Background: Anxiety in children triggered by a scheduled surgical intervention is a major issue due to its frequency, and the short, medium and long term consequences. Aim: To compare different scales to assess preoperative anxiety in children at various points in the build-up to a MAS procedure, and to correlate each with the scale used to assess compliance with anaesthesia induction. Methods: An observational study was carried out on a cohort of children between 2-16 years old that were to undergo major outpatient surgery and whose anxiety was assessed on arrival to the hospital (M0), during transfer to the surgical unit (M1) and in the operating room during anaesthetic induction (M2). Anxiety in the parents (measured on the State-Trait Anxiety Inventory - STAI) and in the children (measured with the Spence Anxiety Scale - Paediatric (SCAS-P), the State-Trait Anxiety Inventory Children (STAIC) and preoperative anxiety measurement scale - m-YPAS) was assessed, and the Induction Compliance Checklist (ICC) was passed. Results: The study cohort included 129 patients aged between 2 and 16 years (75.2% male, median age 6.3 years). Anxiety scores in m-YPAS rose as the children got closer to the surgery, being greater at the entrance to the surgical unit (M0 = 25.8 ± 8.4; M1 = 32.8 ± 19.0; M2 = 34.0 ± 21.5). The m-YPAS scale is closely correlated with the ICC scale at the preoperative M1 (0.567) and M2 stages (0.803). Conclusions: Standard anxiety assessment scales are not able to predict the quality of anaesthetic induction. By contrast, the m-YPAS scale demonstrates that there is an increase in anxiety as the paediatric patient nears the surgical procedure and that it can predict a poor anaesthetic induction.

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Section: Discussionmentioning

confidence: 99%

Comparation Of Different Scales To Assess Preoperative Anxiety In Children And Adolescent Undergoing Major Outpatient Surgery

Vieco-García¹,

Picado²,

Joyanes³

et al. 2020

Preprint

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“…Previous studies reported the effect of parental presence on the day of surgery and during the induction period, which could reduce the child's preoperative anxiety level [33][34][35] . Regarding the hospital's policy, parents were allowed to stay with their children since arrival at the preoperative holding area until starting induction at the operating room.…”

Section: Discussionmentioning

confidence: 99%

Is Emergence Time Related to Emergence Agitation in Pediatric Patients?

pattaravit¹,

Karnjanawanichku²,

Siripruekpong³

et al. 2020

Preprint

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Background: Emergence agitation is one of the unpleasant symptoms after general anesthesia, especially in pediatric patients. This study was designed to evaluate the correlation between emergence time and emergence agitation. The predictors associated with emergence agitation and behavioral changes in children was also determined as specific outcomes.Methods: This prospective cohort study was conducted in children undergoing anesthesia between 3 to 12 years. The preoperative unit nurse evaluated the child's baseline behaviors preoperatively. From pre to post anesthesia period, nurse anesthetist recorded anesthetic management data and clinical emergence time. Meanwhile, the investigator team recorded the Processed-EEG emergence time. At the Post-Anesthetic Care Unit (PACU), the well trained PACU nurse evaluated clinical emergence time and emergence symptoms. For the behavioral symptoms, the investigator team evaluated any changes by telephone interview at postoperative days 1, 3, and 7. Statistical significance was set at p <0.05. Results: Ninety-one pediatric patients were enrolled in the study. Preoperative baseline behaviors were not related to emergence agitation or behavioral changes. There were correlations between clinical emergence time and the incidences of emergence agitation and postoperative separation anxiety. There was no relationship found between processed-EEG emergence time and the incidence of emergence agitation. Multivariate logistic regression analysis showed the significant predictors (ASA physical status, clinical emergence time, and pain) to predict Emergence agitation. (AUC=0.92, sensitivity = 0.89, specificity 0.81). Separation anxiety was significantly higher at postoperative days 1,3 and 7 in the children with emergence agitation (p-values = 0.020, 0.020, and 0.017, respectively).Conclusion: Clinical emergence time significantly related to emergence agitation and postoperative separation anxiety.Trial registration: ClinicalTrials.gov Identifier: NCT03358069. Registered 18 January 2017 - Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007IOW&selectaction=Edit&uid=U0001FGB&ts=2&cx=-7ofx36

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“…It is noted that 40 to 60 per cent of children having surgical procedures suffer high levels of anxiety 1 . Anaesthetic induction can be extremely stressful for children and it may have damaging effects on the child's physiological and mental health 2 . There have been advances in the management of anxiety in paediatric anaesthesia.…”

Section: Introductionmentioning

confidence: 99%