Preoperative informational video reduces preoperative anxiety and postoperative negative behavioral changes in children

BACKGROUND

Anesthesia and surgery can lead to major distress for children. Sedative premedication and preoperative preparation techniques are available to reduce preoperative anxiety in children. We aimed to assess the effect of informational video based on role-play modelling on preoperative anxiety and postoperative behavior changes in children undergoing surgery.

METHODS

Forty-two children aged 5-12 years, with American Society of Anesthesiologist physical status I-II, scheduled for elective outpatient surgery, were enrolled in this study. Patients were randomly allocated to one group with or without information video presentation. In group V, patients watched the information video (N.=21). Other children were verbally informed in a standard care (group C, N.=21). We recorded patient's demographics (age, birth order, surgery time, surgery type, history of previous surgery, parent's age, parental working status, parental education level), the preoperative anxiety level using Modified Yale Preoperative Anxiety Scale (MYPAS) and at 1 week after discharge, new developing postoperative maladaptive behaviors (POMB) using the Post Hospitalization Behavioral Questionnaire by telephone interview.

RESULTS

Patient's demographics were similar in both groups. Total MYPAS scores were found to be lower in group V as compared to group C P=0.0001). Difficulty getting to sleep, nocturnal enuresis, fear of dark, to object to go to bed at night and decreased appetite of new developing POMB were found to be lower in group V than group C. We also found a correlation between anxiety scores and POMB.

CONCLUSIONS

The presentation of an informational video based on model making reduces preoperative anxiety at the time of placement of the facemask and postoperative negative behavioral changes in children.

Comparison of the effects of dexmedetomidine and remiphentanyl on emergence agitation after sevoflurane anesthesia in adults undergoing septoplasty operation: a randomized double-blind trial

OBJECTIVES

Sevoflurane is an ideal agent for anesthesia since its respiratory irritant effect is minimal during mask induction. Emergence agitation (EA) is a common problem after anesthesia with sevoflurane. In this study it was aimed to compare the effects of dexmedetomidine and remifentanyl on emergence agitation after sevoflurane anesthesia in adults undergoing septoplasty operation.

PATIENTS AND METHODS

This prospective, randomized, double-blind study was conducted in Yenimahalle State Hospital after obtaining local Ethics Committee approval and patient's written informed consent. The patients were randomized into dexmedetomidine and remifentanyl groups. Hemodynamic parameters including heart rat, Mean arterial pressure, and sPO2 were recorded. The patients were followed for 1 hour at the recovery room. Categorical data was analyzed using c2 test. Hemodynamic data was evaluated using unpaired t test for intergroup and paired t-test for within group comparisons. Data not normally distributed was compared using Mann Whitney U test. p < 0.05 was considered statistically significant.

RESULTS

Demographic data were similar in both groups (p > 0.05). Riker score was similar in both groups. VAS score was also not significantly different between both groups at the recovery room.

CONCLUSIONS

Our study demonstrated that Dexmedotimidine and Remifentanyl had equal effectiveness in reducing emergence agitation in patients undergoing septoplasty under Sevoflurane anesthesia.