[Parental presence in the operating room: effect on the quality of anesthetic induction and postoperative agitation in children]

Transcultural adaptation into Spanish of the Induction Compliance Checklist for assessing children's behaviour during induction of anaesthesia

OBJECTIVE

Cross-cultural adaptation into Spanish of the Induction Compliance Checklist (ICC) for assessing children's behaviour during induction of anaesthesia.

METHOD

A descriptive cross-sectional observational study was conducted on a sample of 81 children aged 2 to 12 years operated in an ambulatory surgery unit of a paediatric hospital in Barcelona. Adaptation by translation-back translation of the tool and analysis of the scale's validity and reliability.

RESULTS

Face validity of the tool was guaranteed through a discussion group and inter-observer reliability was evaluated, obtaining an intraclass correlation index of r = 0.956.

CONCLUSIONS

The ICC scale validated for the Spanish population can be an effective tool for the presurgical evaluation of activities carried out to minimise children's anxiety. The ICC is an easy-to-use scale completed by operating room staff in one minute and would provide important information about children's behaviour, specifically during induction.

Parental presence at anaesthesia induction: A systematic review

This systematic review assessed the effectiveness of parental presence for children undergoing surgical or diagnostic procedures under general anaesthesia (such as bronchoscopy, laryngoscopy and laparoscopy). Randomized and quasi randomized trials with healthy children scheduled for elective diagnostic and surgical procedures under general anaesthesia (age range 0-16 years) where the intervention was parental presence at anaesthesia induction were included. A comprehensive literature search was conducted using electronic databases and the reference lists of included studies. The Cochrane collaboration's tool for assessing risk of bias was used for assessment of risk of bias. The Review Manager software was used to analyse and synthesize data. A random-effect meta-analysis was used when there was evidence of clinical and/or statistical heterogeneity. Of the 102 citations identified, nine trials involving 1021 children were eligible for inclusion. Only four were sufficient to be included in the meta-analysis. There was no statistically significant difference on average in the level of anxiety in children and their parents either at separation or at induction between children allocated to parental presence and those allocated to no presence, premedication or parental presence plus premedication groups. Significant debate still surrounds this issue, and future trials should focus on the use of reliable and validated tools in assessing outcome measures.

[Evaluation of the scales used to measure anxiety and child behaviour during the induction of anaesthesia. Literature review]

The assessment of children's anxiety during anaesthetic induction is useful to determine if pre-operative strategies have been effective in reducing anxiety. The aim of this study is to review the different tools used to evaluate child anxiety or behaviour during the induction of anaesthesia. The electronic databases with no date limits were reviewed in December 2013, with a second review repeated in September 2014. A data extraction template was applied to find the scales used in the articles. Eight observational scales were found. Six of them can only be used during induction of anaesthesia, and two of those could be applied at various perioperative times, before surgery and during induction of anaesthesia.