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Perioperative anxiety and postoperative behavioural disturbances in children: comparison between induction techniques

Published online by Cambridge University Press:  01 March 2006

N. Bal ,
F. Saricaoglu ,
S. Uzun ,
D. Dal ,
N Çelebi ,
V. Çeliker  and
Ü Aypar
N. Bal
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
F. Saricaoglu
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
S. Uzun
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
D. Dal
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
N Çelebi
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
V. Çeliker
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
Ü Aypar
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
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Extract

Summary

Background and objective: This study was designed to determine if subhypnotic propofol reduces postoperative behavioural disturbances in children undergoing sevoflurane induction compared with intravenous propofol induction for elective adenoidectomy and tonsillectomy. Methods: Following Ethics Committee approval and parental informed consent, ASA I–II, 120 children (2–10 yr) were recruited. Parents were not allowed to accompany their child. Unpremedicated children were randomly allocated to groups receiving inhalation induction with sevoflurane, 2–2.5 mg kg−1 intravenous propofol induction or inhalation induction with sevoflurane followed by subhypnotic dose of propofol (1 mg kg−1). Anaesthesia was maintained with 2–4% sevoflurane, O2 and N2O. Anxiety on arrival to operating theatre, at anaesthesia induction and 30 min after emergence was assessed. Parents completed a state–trait anxiety inventory test preoperatively and a post hospitalization behaviour questionnaire a week later to assess children's postoperative behavioural disturbances. Kruskal–Wallis test, Wilcoxon signed rank sum test, Bonferroni's test, Paired t-test, t-test, Pearson and Spearman's rank correlation test, χ2-test were used for statistical analysis. Results: The anxiety level at induction was high in all groups (P < 0.05). There was no difference between groups in respect to anxiety at other measurement times. A relation between preoperative anxiety level and postoperative behavioural disturbances was determined (P < 0.05). Some behavioural disturbances as nightmare/night fear and desire of sleeping with parents were rarely seen in intravenous propofol induction group (P < 0.05). Conclusion: Addition of subhypnotic dose of propofol to sevoflurane induction did not reduce the incidence of postoperative behavioural disturbances.

Keywords

ANAESTHETICS, INTRAVENOUS, propofolANAESTHETICS, VOLATILE, sevofluranePERIOPERATIVE ANXIETYPOSTOPERATIVE BEHAVIOURAL DISTURBANCE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 6 , June 2006 , pp. 470 - 475
Copyright
© 2006 European Society of Anaesthesiology

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References

Watson AT, Visram A. Children's preoperative anxiety and postoperative behaviour. Paediatr Anaesth 2003; 13: 188–204.Google Scholar
Kain ZN, Mayes LC, Wang SM, Hofstadter MB. Postoperative behavioural outcomes in children: effect of sedative premedication. Anesthesiology 1999; 90: 758–765.Google Scholar
Eckenhoff JE. Relationship of anesthetic to postoperative personality changes in children. Am J Dis Child 1953; 86: 587–591.Google Scholar
Kain ZN, Mayes LC, O'Conner TZ, Ciccetti DV. Preoperative anxiety in children, predictors and outcomes. Arch Pediatr Adolesc Med 1996; 150: 1238–1245.Google Scholar
Bevan JC, Johnston C, Haig MJ et al. Preoperative parental anxiety predicts behavioural and emotional responses to induction of anesthesia in children. Can J Anaesth 1990; 37: 177–182.Google Scholar
Aguilera IM, Patel D, Meakin GH, Masterson J. Perioperative anxiety and postoperative behavioural disturbances in children undergoing intravenous or inhalation of anaesthesia. Paediatr Anaesth 2003; 13: 501–507.Google Scholar
Foesel TH, Reisch HJ. Postoperative behavioural changes in children: comparison between halothane and sevoflurane. Paediatr Anaesth 2001; 11: 719–723.Google Scholar
Veselis RA, Reinsel RA, Feshchcenko VA, Wronski M. The comparative amnestic effects of midazolam, propofol, thiopental and fentanyl at equisedative concentrations. Anesthesiology 1997; 87: 749–764.Google Scholar
Spielberger CD. Manual for the state–trait inventory (STAI: Form Y). Palo Alto: Consulting Psychologists Press, 1983.
Kotiniemi LH, Rhyanen PT. Behavioural changes in children's memories after intravenous, inhalation and rectal induction of anaesthesia. Paediatr Anaesth 1996; 6: 201–207.Google Scholar
Kain ZN, Wang SM, Mayes LC, Caramico LA, Hofstadter MB. Distress during the induction of anesthesia and postoperative behavioral outcomes. Anesth Analg 1999; 88: 1042–1047.Google Scholar
Kotiniemi LH, Rhyanen PT, Moilanen IK. Behavioural changes following routine ENT operations in two-to-ten year old children. Paediatr Anaesth 1996; 6: 45–49.Google Scholar
Kain ZN, Caldwell-Andrews AA, Maranets I et al. Preoperative anxiety and emergence delirium and postoperative maladaptive behaviors. Anesth Analg 2004; 99: 1648–1654.Google Scholar
Keaney A, Diviney D, Harte S, Lyons B. Postoperative behavioral changes following anesthesia with sevoflurane. Paediatr Anaesth 2004; 14: 866–870.Google Scholar
Ryder IG, Spargo PM. Parents in the anaesthetic room. A questionnaire survey of parent's reactions. Anaesthesia 1991; 46: 977–979.Google Scholar
Shirley PJ, Thompson N, Kenward M, Johnston G. Parental anxiety before elective surgery in children. A British perspective. Anaesthesia 1998; 53: 956–959.Google Scholar
Kotiniemi LH, Ryhanen PT, Moilanen IK. Behavioural changes in children following day-case surgery: a 4 week follow-up of 551 children. Anaesthesia 1997; 52: 970–976.Google Scholar
Kain ZN, Mayes LC, Caramico LA et al. Parental presence during induction of anesthesia. A randomized controlled trial. Anesthesiology 1996; 84: 1060–1067.Google Scholar