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Zhong Y, Gong H, Long F, Zhou X, Zhou J, Wang M, Peng T. A bibliometric analysis of research on pediatric preoperative anxiety (2007-2022). Front Pediatr 2024; 12:1327118. [PMID: 38590771 PMCID: PMC10999670 DOI: 10.3389/fped.2024.1327118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/04/2024] [Indexed: 04/10/2024] Open
Abstract
Objective This study aimed to analyze the current state of research on preoperative anxiety in children through CiteSpace, VOSviewer, and the identification of hot spots and frontiers. Method Relevant data were retrieved from the Web of Science Core Collection using the search terms children and preoperative anxiety. Data were analyzed using VOSviewer (version 1.6.18), CiteSpace (5.7. R5) software, and Scimago Graphica. Results A total of 622 articles were published between 2007 and 2022, with an increasing trend over time. Kain, Zeev N. (13; 2.09%) and Dalhousie University (15; 2.41%) were the most influential authors and most prolific institutions, respectively. The United States (121; 19.45%) was the country with the most publications. Pediatric anesthesia (55; 8.84%) had the most publications. High-frequency keywords were categorized into three themes, including nonpharmacologic interventions for preoperative anxiety in children, preoperative medications, and risk factors for anxiety; of these, "predictor" (38; 2016) and "sedative premedication" (20; 2016) were the most studied keywords over the past 6 years. "Distraction" (67; 2019) and "dexmedetomidine" (65; 2019) have been the main areas of interest in recent years. Conclusion Research on preoperative anxiety in children has been the focus of increasing attention over the past fifteen years, with the majority of publications from high-income countries. This review provides a useful perspective for understanding research trends, hot topics, and research gaps in this expanding field.
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Affiliation(s)
- Yue Zhong
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
| | - Huishu Gong
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
| | - Feiyu Long
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
| | - Xingchen Zhou
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
| | - Jun Zhou
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
| | - Maohua Wang
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
| | - Tao Peng
- Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
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Yeniay D, Tamdo An L, Yucak Ozdemir A, Ak An LO, Kay R SU. Effects of Videos and Therapeutic Music on Preoperative Anxiety and Postoperative Anxiety and Pain Levels in Boys Who Undergo Circumcision. J Perianesth Nurs 2023; 38:918-924. [PMID: 37589631 DOI: 10.1016/j.jopan.2023.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE This purpose of this study was to investigate the effects of having boys aged 5 to 10 years who will undergo circumcision surgery watch informative videos and listen to therapeutic music on preoperative anxiety, and postoperative anxiety, pain, and nausea and vomiting. DESIGN This was a prospective and ranomized controlled study. MATERIALS AND METHODS The sample consisted of 90 boys aged 5 to 10 years who underwent circumcision surgery. The boys included in the study were randomly divided into 3 groups of 30 using a computer program. The first group (group V) watched the video; the second group (group M) listened to the music, and the third group (group C) was the control group with usual care. Boys and their parents were not blinded to the grouping. FINDINGS Heart rate.ßvalues were found to be statistically significantly lower compared to the control group at the 1st minute after local anesthesia in group V (P.ß=.ß.029), at the 5th minute after local anesthesia in group M (P.ß=.ß.030), and at the 10th minute after local anesthesia and after the surgery in both group V and group M (P.ß=.ß.001 and P.ß=.ß.010, respectively). Wong-Baker Faces Pain Rating Scale.ßscores of the control group measured at the 2nd postoperative hour were found to be significantly higher than those of group V (P.ß=.ß.018). Children's Fear Scale.ßscores of group V measured at the time of admission to the postoperative service were found to be significantly higher than those of group M and group C (P.ß<.ß.001). There was no significant difference between the groups in terms of additional analgesic use, nausea and vomiting percentages, and time to discharge. CONCLUSIONS The results of this study revealed that having boys aged 5 to 10 years who will undergo circumcision surgery watch informative videos and listen to therapeutic music did not have any significant effect on their postoperative pain, fear, and anxiety levels. Further large-scale studies, which will also include children who will not undergo circumcision surgery, are needed to generalize this study's results to larger populations.
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Affiliation(s)
- Dilek Yeniay
- Department of Anesthesiology and Reanimation, Giresun Maternity and Child Health Training and Research Hospital, Giresun, Turkey.
| | - Lke Tamdo An
- Department of Anesthesiology and Reanimation, Giresun Maternity and Child Health Training and Research Hospital, Giresun, Turkey
| | - Aysel Yucak Ozdemir
- Department of Pediatric Surgery, Giresun Maternity and Child Health Training and Research Hospital, Giresun, Turkey
| | - Lknur Okur Ak An
- Department of Radiology, Giresun Maternity and Child Health Training and Research Hospital, Giresun, Turkey
| | - Sel Uk Kay R
- Department of Anesthesiology and Reanimation, Hitit University, ..orum, Turkey
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Abstract
AIMS Several kinds of drugs have been investigated in preschool children as a preanesthetic sedation after various routes of administration for surgeries. This study aims to compare the efficacy of promethazine and oral midazolam for premedication in children aged 3 to 9 years who were scheduled for surgeries. METHODS This is a double-blind randomized controlled study conducted on 93 patients between the age of 3 and 9 years at Loresten University of Medical Sciences Teaching Hospital, Khoramabad, Iran. The subjects were grouped into P (promethazine), M (midazolam), and C (control). About 0.3 mg/kg of oral promethazine was administered to patients in group P, 0.5 mg/kg of oral midazolam was administered to patients in group M, and 3 mL of normal saline as placebo was administered to patients in group C. Patient satisfaction, sedation and emotional score, systolic blood pressure (SBP), diastolic blood pressure, respiratory rate (RR), and heart rate (HR) were recorded. RESULTS There was no statistically significant difference among the 3 groups. However, the period after medication, it was observed that SBP, diastolic blood pressure, RR, and HR in group C were statistically significantly higher than those in groups M and P. These 2 groups are similar in terms of SBP, RR, and HR. The emotional scores were comparable for the 2 groups. It was between 3.97 ± 0.6 to 1.7 ± 0.5 in group M and from 3.45 ± 1.17 to 2.745 ± 0.997 in group P in a Kruskal-Wallis test. CONCLUSIONS This study shows that both test groups reduce stress at the time of anesthetic induction and separation from their parents with similar effect. Both of the anesthetics are easily administered without the necessity of an additional equipment. A shorter period to maximal sedation for midazolam is an advantage, thus, making the drug helpful, mostly in the outpatient setting.
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Cheng X, Chen Z, Zhang L, Xu P, Qin F, Jiao X, Wang Y, Lin M, Zeng L, Huang L, Yu D. Efficacy and Safety of Midazolam Oral Solution for Sedative Hypnosis and Anti-anxiety in Children: A Systematic Review and Meta-Analysis. Front Pharmacol 2020; 11:225. [PMID: 32256348 PMCID: PMC7093581 DOI: 10.3389/fphar.2020.00225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/19/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Midazolam is recommended by health guidelines for sedation and hypnosis in children. Oral solution is a suitable dosage form for children. But there is no conclusive evidence for sedative-hypnosis and antianxiety effects by midazolam oral solution in children. Methods: Relevant studies were identified through searching PubMed, Embase, Cochrane Library, CINAHL, International Pharmaceuticals, four Chinese electronic databases, and relevant lists. Two reviewers independently selected trials, assessed trial quality, and extracted the data. Results: Eighty-nine randomized controlled trials (RCTs) comparing midazolam oral solution with placebo or blank (n = 33), dexmedetomidine (n = 15), ketamine (n = 11), different midazolam doses (n = 10), midazolam injection (n = 8), chloral hydrate (n = 7), diazepam (n = 5), N2O (n = 5), triclofos (n = 4), butorphanol (n = 2), fentanyl (n = 2), hydroxyzine (n = 1), and thiopental (n = 1) were identified. Meta-analysis showed no significant difference in the success rate and duration of sedation and hypnosis between midazolam oral and injectable solution (P > 0.05). The success rate of sedation and hypnosis of midazolam was higher than that of ketamine [risk ratio (RR) = 1.32, 95% CI (1.07, 1.62), I 2 = 0%, P < 0.01]. No significant difference was found in the success rate of sedation and hypnosis, mask acceptance, and parental separation between midazolam oral solution and dexmedetomidine (P > 0.05), and the result of one cohort study was consistent. The results of RCTs and a prospective cohort study showed that the incidence of adverse drug reactions (ADR) was 19.57% (189/966). Incidence of adverse reactions between dose groups of (0.25, 0.5] and (0.5, 1.0] mg/kg was similar [Pf (95% CI) = 0.10 (0.04, 0.24) and Pf (95% CI) = 0.09 (0.02, 0.39), respectively], higher than that of the dose group of (0, 0.25] mg/kg [Pf (95% CI) = 0.01 (0.00, 0.19)]. Conclusions: Available evidence suggests that midazolam oral solution is as good as midazolam injection and dexmedetomidine and is better than ketamine. Based on efficacy and safety results, an oral midazolam solution dose of 0.5-1 mg/kg is recommended for children.
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Affiliation(s)
- Xiao Cheng
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Zhe Chen
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Lingli Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Peipei Xu
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Fang Qin
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Xuefeng Jiao
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Yiyi Wang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Mao Lin
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Linan Zeng
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Liang Huang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Dan Yu
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
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Song B, Yang Y, Teng X, Li Y, Bai W, Zhu J. Use of pre-operative anxiety score to determine the precise dose of butorphanol for intra-operative sedation under regional anesthesia: A double-blinded randomized trial. Exp Ther Med 2019; 18:3885-3892. [PMID: 31611935 PMCID: PMC6781787 DOI: 10.3892/etm.2019.8040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/30/2019] [Indexed: 11/17/2022] Open
Abstract
A randomized double-blinded controlled trial was performed to explore the association between pre-operative anxiety and intra-operative butorphanol requirement to evaluate the precise sedative requirement and to confirm the sedative effect of butorphanol in patients receiving lower-limb orthopedic surgery. The Amsterdam pre-operative anxiety and information scale and the Ramsay sedation score (RSS) were used to assess the patients' pre-operative anxiety score and sedation state during surgery. Patients were divided into two groups according to their pre-operative anxiety score prior to administration of pre-medication. Patients in each group were randomly divided into a butorphanol group and a 0.9% saline group. A total of 142 patients were enrolled and 131 patients were analyzed. The sedation scores of patients with high pre-operative anxiety in the 0.9% saline group were lower than those in the butorphanol group at each time-point after infusion. An increased pre-operative anxiety score predicted an increased duration to reach an RSS of 4 for an acceptable level of sedation (r2=0.887, P<0.0001). In conclusion, butorphanol had a good sedative effect on patients with pre-operative anxiety. The following formula was proposed: Precise dose of butorphanol (µg/kg)=15.26 + (0.14× pre-operative anxiety score), which may provide an improvement for patients exhibiting a high level of pre-operative anxiety. The trial was registered prior to patient enrollment at clinicaltrials.gov on 20.01.2018 (trial registration no. NCT03429179).
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Affiliation(s)
- Bijia Song
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Yanchao Yang
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Xiufei Teng
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Yang Li
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Wenya Bai
- Department of Anesthesiology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, P.R. China
| | - Junchao Zhu
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
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Abstract
OBJECTIVES To examine the feasibility, acceptability, and effects of a novel tablet-based application, Story-Telling Medicine (STM), in reducing children's preoperative anxiety. METHODS Children (N = 100) aged 7 to 13 years who were undergoing outpatient surgery were recruited from a local children's hospital. This study comprised 3 waves: Waves 1 (n = 30) and 2 (n = 30) examined feasibility, and Wave 3 (n = 40) examined the acceptability of STM and compared its effect on preoperative anxiety to Usual Care (UC). In Wave 3, children were randomly allocated to receive STM+UC or UC. A change in preoperative anxiety was measured using the Children's Perioperative Multidimensional Anxiety Scale (CPMAS) 7 to 14 days before surgery (T1), on the day of surgery (T2), and 1 month postoperatively (T3). RESULTS Wave 1 demonstrated the feasibility of participant recruitment and data collection procedures but identified challenges with attrition at T2 and T3. Wave 2 piloted a modified protocol that addressed attrition and increased the feasibility of follow-up. In Wave 3, children in the STM+UC demonstrated greater reductions in CPMAS compared with the UC group (ΔM = 119.90, SE = 46.36, t(27) = 2.59, p = .015; 95% confidence interval = 24.78-215.02). CONCLUSION This pilot study provides preliminary evidence that STM is a feasible and acceptable intervention for reducing children's preoperative anxiety in a busy pediatric operative setting and supports the investigation of a full-scale randomized controlled trial.
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Kubiak M, Roach L, Eatwell K. The Influence of a Combined Butorphanol and Midazolam Premedication on Anesthesia in Psittacid Species. J Avian Med Surg 2016; 30:317-323. [DOI: 10.1647/2013-072] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tsukamoto A, Uchida K, Maesato S, Sato R, Kanai E, Inomata T. Combining isoflurane anesthesia with midazolam and butorphanol in rats. Exp Anim 2016; 65:223-30. [PMID: 26876437 PMCID: PMC4976236 DOI: 10.1538/expanim.15-0113] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Representative inhalant anesthetic agent, isoflurane is commonly used during surgery in
rats. However, isoflurane mediates relatively strong respiratory depression. In human and
veterinary medicine, sedatives and analgesics are co-administered to complement the
anesthetic action of inhalant anesthesia. The present study aimed to establish the novel
balanced anesthesia that combines midazolam and butorphanol with isoflurane (MBI) in rats.
Male Sprague Dawley rats were divided into 2 groups, and administered either isoflurane
monoanesthesia or isoflurane with midazolam (2.5 mg/kg, ip) and butorphanol (2.0 mg/kg,
ip). The minimum alveolar concentration (MAC) in each group was evaluated. Induction and
recovery times were measured in each group. Adverse reactions during induction were also
recorded. In each group, vital signs were assessed for 1 h under 1.5×MAC of isoflurane.
Instability of vital signs was assessed under each anesthesia by calculating coefficient
of variance. Compared with isoflurane monoanesthesia, MBI anesthesia caused 32% MAC
reduction (isoflurane monoanesthesia: 1.30 ± 0.09%, MBI 0.87 ± 0.08%,
P<0.05). MB premedication mediated smooth sedating action with low
incidence of adverse reactions such as urination and defecation. Isoflurane
monoanesthsesia remarkably decreased respiratory rate and saturation O2
(SPO2). In contrast, MBI anesthesia resulted in a relatively stable
respiratory rate without decreases in SPO2 during the anesthetic period. In
summary, MB premedication is effective for attenuating respiratory depression induced by
isoflurane, and achieving smooth induction. This anesthetic protocol serves as a novel
option for appropriate anesthesia in rats.
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Affiliation(s)
- Atsushi Tsukamoto
- Laboratory of Laboratory Animal Science, Azabu University, School of Veterinary Medicine, 1-17-71 Fuchinobe, Chuou-ku, Sagamihara, Kanagawa 252-5201, Japan
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Analgesic effect and pharmacological mechanism of fentanyl and butorphanol in a rat model of incisional pain. J Clin Anesth 2016; 28:67-73. [DOI: 10.1016/j.jclinane.2015.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 04/21/2015] [Accepted: 08/13/2015] [Indexed: 11/23/2022]
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Chow CHT, Van Lieshout RJ, Schmidt LA, Dobson KG, Buckley N. Systematic Review: Audiovisual Interventions for Reducing Preoperative Anxiety in Children Undergoing Elective Surgery. J Pediatr Psychol 2015; 41:182-203. [PMID: 26476281 DOI: 10.1093/jpepsy/jsv094] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 09/11/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine the effectiveness of Audiovisual (AV) interventions at reducing preoperative anxiety and its associated outcomes in children undergoing elective surgery. METHODS A systematic review of randomized controlled trials (RCTs) and nonrandomized studies where the primary outcome was children's preoperative anxiety was conducted. Secondary outcomes included postoperative pain, behavioral changes, recovery, induction compliance, satisfaction, and cost-effectiveness. The risk of bias of each study was assessed. RESULTS In all, 18 studies were identified. A meta-analytic approach and narrative synthesis of findings were used to summarize the results of the studies. CONCLUSIONS This systematic review suggests that AV interventions can be effective in reducing children's preoperative anxiety. Videos, multi-faceted programs, and interactive games appear to be most effective, whereas music therapy and Internet programs are less effective. While AV interventions appear potentially useful, adequately powered RCTs are required to conclusively pinpoint the components and mechanisms of the most effective AV interventions and guide practice.
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Affiliation(s)
| | - Ryan J Van Lieshout
- MiNDS Neuroscience Graduate Program, Department of Psychiatry & Behavioral Neurosciences
| | - Louis A Schmidt
- MiNDS Neuroscience Graduate Program, Department of Psychology, Neuroscience & Behavior
| | | | - Norman Buckley
- Department of Anesthesia, McMaster University, Ontario, Canada
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Bansal R, Khan Joad AS, Saxena M, Hemrajani M. Oral midazolam is a safe and effective premedication in adult outpatients undergoing brachytherapy for cancer cervix under general anaesthesia: A prospective randomised, double blind placebo-controlled study. Indian J Anaesth 2015; 59:437-9. [PMID: 26257418 PMCID: PMC4523966 DOI: 10.4103/0019-5049.160955] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Rakhi Bansal
- Department of Anaesthesia, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
| | - Anjum S Khan Joad
- Department of Anaesthesia and Palliative Care Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India
| | - Meenakshi Saxena
- Department of Anaesthesia and Palliative Care Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India
| | - Manisha Hemrajani
- Department of Anaesthesia and Palliative Care Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India
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Tsukamoto A, Iimuro M, Sato R, Yamazaki J, Inomata T. Effect of midazolam and butorphanol premedication on inhalant isoflurane anesthesia in mice. Exp Anim 2015; 64:139-45. [PMID: 25736585 PMCID: PMC4427728 DOI: 10.1538/expanim.14-0073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Isoflurane is a representative inhalant anesthesia used in laboratory animals. However, isoflurane mediates respiratory depression and adverse clinical reactions during induction. In the present study, we established a novel balanced anesthesia method in mice that combined isoflurane anesthesia with midazolam and butorphanol (MB). Thirty-four male C57BL/6J mice received either isoflurane alone or isoflurane with an intra-peritoneal MB premedication (3 mg/kg midazolam and 4 mg/kg butorphanol). The minimum alveolar concentration (MAC) in each group was evaluated. Induction time and adverse clinical reactions were recorded in each group. Core body temperature, heart rate, respiratory rate, and oxygen saturation (SPO(2)) were assessed before and for 1 h after induction. Premedication with MB achieved a significant reduction in MAC compared with isoflurane monoanesthesia (isoflurane, 1.38 ± 0.15%; isoflurane with MB, 0.78 ± 0.10%; P<0.05). Induction time was significantly shortened with MB premedication, and adverse reactions such as excitement or incontinence were observed less frequently. Furthermore, isoflurane anesthesia with MB premedication caused increase of respiratory rates compared to isoflurane monoanesthesia. No significant decrease of SPO(2) was observed in MBI anesthesia, while a decrease in SPO(2) was apparent with isoflurane monoanesthesia (baseline, 98.3% ± 1.1; 10 min after induction, 91.8 ± 6.4%; P<0.05). In conclusion, premedication with MB was effective for the mitigation of respiratory depression induced by isoflurane in mice, with rapid induction and fewer adverse clinical reactions.
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Affiliation(s)
- Atsushi Tsukamoto
- Laboratory of Laboratory Animal Science, Azabu University, School of Veterinary Medicine, 1-17-71 Fuchinobe, Chuou-ku, Sagamihara, Kanagawa 252-5201, Japan
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Kalibatienė L, Kalibatas V, Macas A, Trepenaitis D. An evaluation of the effectiveness and safety of midazolam in children undergoing dental surgery. MEDICINA-LITHUANIA 2015; 51:180-186. [PMID: 28705481 DOI: 10.1016/j.medici.2015.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 04/04/2015] [Accepted: 04/22/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness and safety of oral midazolam in children undergoing dental surgery. MATERIALS AND METHODS A prospective, randomized, controlled trial was conducted to assess the effectiveness and safety of midazolam in children. Patients aged 2-9 years who underwent dental surgery under general anesthesia were randomly allocated into one of the four groups: midazolam 0.2mg/kg dose group (n=30); midazolam 0.21-0.4mg/kg dose group (n=15); midazolam more than 0.41mg/kg dose group (n=15) or the placebo group (n=31). The effectiveness of midazolam on sedation was assessed by the evaluation of vital signs, such as the respiratory and heart rate, oxygen saturation and the patients' reactive behaviors, in comparison with the placebo. RESULTS The scores of the ratings for sleep, movement and crying, as well as patients' reactions at the moment of separation from their parents and their collaboration with the staff were statistically significantly better among patients who received oral midazolam compared with the placebo. There were statistically significant direct correlations between the doses of midazolam and higher sleep, movement, crying and reaction scores 30min after premedication as well as higher scores of patients upon separation from their parents. There were only a few clinically insignificant side effects. CONCLUSIONS Oral midazolam, at a single dose from 0.2 to 0.6mg/kg, is effective and safe, and provides the expected sedative effects in children required by premedication for dental surgery.
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Affiliation(s)
- Lina Kalibatienė
- Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Vytenis Kalibatas
- Department of Health Management, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Andrius Macas
- Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Darius Trepenaitis
- Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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