Current practice of pre-anaesthesia preparation and perioperative parental satisfaction during paediatric ambulatory procedures in a developing country — An observational study

Mathew, Preethy J; Regmi, Sadikshya; Ashok, Vighnesh; Menon, Prema

doi:10.1016/j.accpm.2019.10.019

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…In line with these data, Du et al (2020) and Mathew et al (2020) found that preoperative anxiety was associated with decline in the domain of executive function, and low educational attainment is a risk factor of overall neurocognitive disorder and suggested the need for preparatory program. These data assured the value of preoperative anesthetic consultation applied for the study participants of the current study.…”

Section: Discussionmentioning

confidence: 57%

Preoperative oral melatonin can reduce preoperative anxiety and postoperative analgesia in a dose-dependent manner

Lotfy

Ayaad

2021

Ain-Shams J Anesthesiol

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Background Preoperative anxiety has deleterious effects on patients’ outcome through its influence on intraoperative requirements of anesthetics and analgesics (Bayrak et al., J Coll Physicians Surg Pak 29:868–873, 2019), postoperative (PO) pain intensity, and analgesia requirement, and may even increase PO morbidity and mortality after certain types of surgery. Melatonin is a methoxyindole synthesized and secreted principally by the pineal gland at night under control of an endogenous rhythm of secretion generated by the suprachiasmatic nuclei. The current study hypothesized that preoperative melatonin could reduce patients’ anxiety and reduce intraoperative (IO) and postoperative (PO) analgesic in a dose-dependent manner. Results Preoperative consultation was, to some extent, effective in reducing patients’ anxiety and apprehension. At 1 h after receiving premedication, Anxiety Specific to Surgery Questionnaire (ASSQ) scores were significantly lower in study groups in comparison to baseline scores and at 1 h scores of P group patients (patients who received 3 ml of plain distilled water), and this significant effect extended for 3-h PO. The reported ∆∆ASSQ between study groups was 25.9% between M2 (melatonin) and Z (midazolam) groups and 36.9% between groups M1 (received melatonin in a dose of 3 mg) and M2 (received melatonin in a dose of 6 mg). Preoperative anxiolytic therapy allowed reduction of PO pain scores and analgesia consumption with prolongation of duration till 1st request of rescue analgesia, and these effects were more pronounced with melatonin 6 mg in comparison to placebo, melatonin 3mg, or midazolam. Conclusion Preoperative melatonin is an appropriate policy for reduction of preoperative anxiety and provided reduction of PO anxiety, pain scores, and consumption of analgesia thus promoting early recovery and short PO hospital stay. Dose dependency was evident, and preoperative melatonin 6-mg dose provided satisfactory effect.

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Section: Discussionmentioning

confidence: 57%

Preoperative oral melatonin can reduce preoperative anxiety and postoperative analgesia in a dose-dependent manner

Lotfy

Ayaad

2021

Ain-Shams J Anesthesiol

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“…A majority of parents in our setting accept a physician’s advice readily and are hesitant to actively seek information regarding anesthesia or surgical complications. [ 13 ] This is in contrast to parental expectations for detailed information in the developed countries. Family-centric specific psychologic preoperative preparatory programs are integrated into a majority of Western centers with an emphasis on non-pharmacological interventions to lessen preop anxiety of children.…”

Section: Discussionmentioning

confidence: 85%

Assessment of potential predictors affecting preoperative anxiety in Indian children- A prospective observational study

Mathew

Gopinath

Gupta

et al. 2022

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: Preoperative anxiety is a common problem among children undergoing surgery. The aim of the study was to assess the incidence and identify various predictors of preoperative anxiety in Indian children. Material and Methods: A prospective, observational study was conducted on 60 children of the American Society of Anesthesiologists Physical status 1/2, aged 2–6 years and scheduled for elective surgery under general anesthesia in a tertiary care teaching hospital. Preoperative parental anxiety was assessed using the State-Trait Anxiety Inventory questionnaire. The children’s anxiety was assessed in the preoperative room, at the time of parental separation, and at the induction of anesthesia using modified Yale Preoperative Anxiety Scale (mYPAS) scoring by an anesthesiologist and a psychologist. Sedative premedication was employed prior to parental separation. Logistic regression analysis was carried out to identify the possible predictors of anxiety. Results: The incidence of high preoperative anxiety among the studied children was 76% in the preoperative room, 93% during parental separation, and 96% during anesthetic induction. Among the nine possible predictors identified on univariate regression, the presence of siblings was found to be a significant independent predictor on multivariate regression analysis ( P = 0.04). The inter-rater agreement was excellent for the assessment of preoperative anxiety using mYPAS by the anesthesiologist and psychologist (weighted Kappa, k = 0.79). Conclusion: The incidence of preoperative anxiety in Indian children in the age group of 2–6 years is very high. The preop anxiety escalates progressively at parental separation and induction of anesthesia despite sedative premedication. The presence of siblings is a significant predictor of preoperative anxiety.

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“…We found that while the level of knowledge and information regarding anesthesia was poor amongst caregivers, a significant proportion of them were open to receiving more details concerning general anesthesia of their child. We also observe that preoperative information sharing in LMIC setting is often nonstandardized, highly variable, surgery‐centric and not essentially family‐centric 5 . This is an area that needs further examination and analysis to evaluate the challenges to overcome caregiver anxiety.…”

mentioning

confidence: 88%

“…From our experience, we agree with Knoetze R et al 1 that preoperative screening for caregiver anxiety can identify children at a higher risk of experiencing postsurgical pain and that interventions aimed to specifically reduce this anxiety should be part of the overall perioperative management of children. One key intervention to reduce caregiver anxiety is related to the need for improved information sharing with the family regarding anesthesia and surgery preoperatively 5 . We found that while the level of knowledge and information regarding anesthesia was poor amongst caregivers, a significant proportion of them were open to receiving more details concerning general anesthesia of their child.…”

mentioning

confidence: 91%

Scope for improving information sharing to reduce caregiver anxiety in a low‐middle‐income country setting

Ashok

Mathew

2021

Pediatric Anesthesia

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Current practice of pre-anaesthesia preparation and perioperative parental satisfaction during paediatric ambulatory procedures in a developing country — An observational study

Cited by 7 publications

References 11 publications

Preoperative oral melatonin can reduce preoperative anxiety and postoperative analgesia in a dose-dependent manner

Preoperative oral melatonin can reduce preoperative anxiety and postoperative analgesia in a dose-dependent manner

Assessment of potential predictors affecting preoperative anxiety in Indian children- A prospective observational study

Scope for improving information sharing to reduce caregiver anxiety in a low‐middle‐income country setting

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