Does a Preparation Program Decrease Preoperative Anxiety in Children and Parents?

1994 ◽  
Vol 81 (SUPPLEMENT) ◽  
pp. A1363
Author(s):  
Z. N. Kain ◽  
L. Mayes ◽  
M. Nygren ◽  
M. Speiker ◽  
C. Brandriff ◽  
...  
2014 ◽  
Vol 36 (5-6) ◽  
Author(s):  
M. Messina ◽  
F. Molinaro ◽  
D. Meucci ◽  
R. Angotti ◽  
L. Giuntini ◽  
...  

Anxiety in children undergoing surgery is characterized by feelings of tension, apprehension, nervousness and fear which may manifest differently. Postoperative behavioural changes such as nocturnal enuresis, feeding disorders, apathy, and sleep disturbances may stem from postoperative anxiety. Some Authors pointed out that over 60% of children undergoing surgery are prone to developing behavioural alterations 2 weeks after surgery. Variables such as age, temperament and anxiety both in children and parents are considered predictors of such changes.1 Studies were published describing how psycho-behavioural interventions based on play, learning and entertainment in preparing children for surgery, may reduce preoperative anxiety. Clown-therapy is applied in the most important paediatric facilities and has proved to diminish children’s emotional distress and sufferance, as well as consumption of both analgesics and sedatives and to facilitate the achievement of therapeutic goals. The aim of our study was to evaluate the efficacy of clown-therapy during the child’s hospital stay, with a view to optimizing treatment and care, preventing behavioural alterations and enhancing the child’s overall life quality.


This case focuses on using anesthesia on children and the effects of calming the child by having their parents present. This case asks the question: Is a pharmacologic intervention (midazolam premedication) or a behavioral intervention (parental presence) more effective in reducing anxiety of children undergoing surgery? This randomized controlled trial demonstrated that premedication with oral midazolam was more effective at reducing preoperative anxiety in both children and parents than parental presence during induction. Furthermore, premedicated children were more compliant with induction.


2007 ◽  
Vol 106 (1) ◽  
pp. 65-74 ◽  
Author(s):  
Zeev N. Kain ◽  
Alison A. Caldwell-Andrews ◽  
Linda C. Mayes ◽  
Megan E. Weinberg ◽  
Shu-Ming Wang ◽  
...  

Background Children and parents experience significant anxiety and distress during the preoperative period. Currently available interventions are having limited efficacy. Based on an integration of the literature in both the anesthesia and psychological milieus, the authors developed a behaviorally oriented perioperative preparation program for children undergoing surgery that targets the family as a whole. Methods Children and their parents (n = 408) were randomly assigned to one of four groups: (1) control: received standard of care; (2) parental presence: received standard parental presence during induction of anesthesia; (3) ADVANCE: received family-centered behavioral preparation; and (4) oral midazolam. The authors assessed the effect of group assignment on preoperative anxiety levels and postoperative outcomes such as analgesic consumption and emergence delirium. Results Parents and children in the ADVANCE group exhibited significantly lower anxiety in the holding area as compared with all three other groups (34.4+/-16 vs. 39.7+/-15; P=0.007) and were less anxious during induction of anesthesia as compared with the control and parental presence groups (44.9+/-22 vs. 51.6+/-25 and 53.6+/-25, respectively; P=0.006). Anxiety and compliance during induction of anesthesia was similar for children in both the ADVANCE and midazolam groups (44.9+/-22 vs. 42.9+/-24; P=0.904). Children in the ADVANCE group exhibited a lower incidence of emergence delirium after surgery (P=0.038), required significantly less analgesia in the recovery room (P=0.016), and were discharged from the recovery room earlier (P=0.04) as compared with children in the three other groups. Conclusion The family-centered preoperative ADVANCE preparation program is effective in the reduction of preoperative anxiety and improvement in postoperative outcomes.


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