Parent and Physician Preference for Anxiolytic Medication Prior to Laceration Repair in Young Children

Abstract

Pediatric laceration repair is a daunting process for parents and physicians. The repair could take place quickly if the child is calm and relaxed.This study aimeds to evaluate parental and physician preference for anxiolytic medication administration prior to laceration repair, with a pre-and post-repair survey on parents' and physicians' initial preference and follow-up perception. MethodsParents or guardians of children aged six months to five years who presented with simple lacerations and their physicians were asked to complete a survey on potential benefits and expectations of anxiolytic use before and after the laceration repair. ResultsFifty parents/guardians completed the survey. Forty-three (86%) expressed their preference for anxiolytic medication use if it had been available, before laceration repair. Parents/guardians perceived reactions to laceration repair before and after the procedure were significant, ranging from "uncontrolled crying" to "continuous crying" (p=.032). The parents/guardians overwhelmingly preferred to take part in the decisionmaking process during the repair (not significant). Preference for anxiolytic use was high before repair at 54% and increased to 62% after witnessing the procedure (not significant). Physicians who completed the survey supported the use of anxiolytics 84% of the time. Forty (80%) physicians preferred the intranasal route, while parents/guardians preferred the oral route (58%). ConclusionsProcedural sedation is critical for anxiety control and to minimize the difficulties related to treatment. In our study, parents and physicians supported the administration of an anxiolytic agent to help alleviate anxiety and achieve optimal outcomes.

Intranasal drug delivery in pediatric emergency departments: brief review and future outlook

“…A 2022 survey in New York City found that the treating pediatric EPs would prefer IN anxiolysis using any medication prior to laceration repair 89% of the time, and PO anxiolysis using any medication 11% of the time (43). In a 2023 study of 94 patients undergoing PSA in Spain, the treating EPs chose a single IN drug 16.6% of the time, and a combination of drugs including 1 or more IN medications 16.5% of the time (see Table 3 IN drugs can generally be divided into 3 categories: drugs with a central mechanism of action, drugs with a local mechanism of action, and drugs intended to treat CNS pathology (11,12).…”