Perioperative Behavior Stress in Children

A Practice of Anesthesia for Infants and Children

Volumn , Issue , 2009, Pages 25-35

  Kain, Zeev N ^a,b   MacLaren, Jill ^b   Mayes, Linda C ^c  

^a Department of Anesthesiology ^*  (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 84880629906     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1016/B978-141603134-5.50007-X     Document Type: Chapter

References (127)

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123. Children were assigned to parental presence at induction (PPIA), premedication with midazolam, PPIA + premedication, or no intervention at initial surgery. Children were then followed up at subsequent surgery and parental preference for intervention was assessed. Of parents whose children were assigned to PPIA, 70% would choose PPIA as intervention again. Of those assigned to premedication, only 23% would choose premedication again. Regardless of prior intervention, parents at subsequent surgery favored PPIA. Children's and parents' anxiety also affected parental preference for intervention.
124. This study evaluated the efficacy of a family-centered behavioral preparation program (ADVANCE) for children undergoing outpatient surgery (n = 408). Children were randomly assigned to no intervention, ADVANCE + PPIA, PPIA without advance, and midazolam premedication. Children in ADVANCE + PPIA displayed significantly less anxiety at induction than no intervention or PPIA alone. Anxiety and compliance in the ADVANCE + PPIA group were comparable to premedication. ADVANCE + PPIA was superior to all other groups on postoperative recovery variables.
125. These researchers assessed children's memory at baseline and in four randomly assigned groups (5, 10, and 20 minutes post midazolam administration, and no midazolam [control]) of children (n = 118). Compared with controls, recall memory was impaired for children in the 10- and 20-minute post-midazolam groups. All midazolam groups demonstrated recognition deficits when compared with controls. In terms of perioperative anxiety, significant effects of midazolam were evidenced at approximately 15 minutes.
126. This study assessed preoperative anxiety and postoperative pain and behavioral outcomes after surgery in 241 children. Children who displayed more preoperative anxiety were rated as having higher pain after surgery by their parents. Anxious children also consumed more analgesics at home after surgery and were more likely to experience emergence delirium and postoperative sleep disturbances.
127. Eighty-eight children undergoing outpatient surgery were randomly assigned to parental presence at anesthesia induction, midazolam premedication, or no intervention. Children in the midazolam group exhibited significantly less perioperative anxiety than children in the parental presence or no intervention groups.