Non-pharmacological interventions for assisting the induction of anaesthesia in children

Abstract

This review shows that the presence of parents during induction of general anaesthesia does not reduce their child's anxiety. Promising non-pharmacological interventions such as parental acupuncture; clown doctors; hypnotherapy; low sensory stimulation; and hand-held video games needs to be investigated further.

Parental presence, clowns or sedative premedication to treat preoperative anxiety in children: what could be the most promising option?

“…These results are consistent also with those of other studies that compare the use of midazolam to alternative interventions for managing preoperative anxiety in children (3,13,16): the results of one of these studies show that music therapy may be helpful on separation and entrance to the OR (depending on the therapist), but it does not appear to relieve anxiety during the induction of anesthesia (16). We can hypothesize that the clowns have a greater effect than music during induction because they involve the child actively performing gags, which are not standardized but created for every individual child.…”

Parental presence, clowns or sedative premedication to treat preoperative anxiety in children: what could be the most promising option?

“…These results are consistent also with those of other studies that compare the use of midazolam to alternative interventions for managing preoperative anxiety in children (3,13,16): the results of one of these studies show that music therapy may be helpful on separation and entrance to the OR (depending on the therapist), but it does not appear to relieve anxiety during the induction of anesthesia (16). We can hypothesize that the clowns have a greater effect than music during induction because they involve the child actively performing gags, which are not standardized but created for every individual child.…”

Clown intervention to reduce preoperative anxiety in children and parents: A randomized controlled trial

“…Due to the lack of variables tested, we cannot assess the relationship. This result supports the conclusions of a Cochrane review, where it appears that the presence of parents during induction of general anesthesia does not reduce children's anxiety (Yip et al, 2009). Furthermore, this finding is consistent with the study of Fernandes and Arriaga (2010) that discovered that the child's emotionality and parental state anxiety associations are not strong enough to predict child worries when considering the relevance of clown intervention.…”

Analysis of Trajectories of Anxiety Behaviors During Induction of Anesthesia in Children With Multiple Encounters: A Secondary Analysis of a Multicenter Retrospective Cohort Study

“…Consistent with previous findings, younger age, autism diagnosis, and PPIA were linked to higher odds of difficult inductions [16]. Children aged 1-12 years showed the greatest reduction in difficult inductions over multiple visits in NORA but not OR environment.…”

Parental presence, clowns or sedative premedication to treat preoperative anxiety in children: what could be the most promising option?

“…These results are consistent also with those of other studies that compare the use of midazolam to alternative interventions for managing preoperative anxiety in children (3,13,16): the results of one of these studies show that music therapy may be helpful on separation and entrance to the OR (depending on the therapist), but it does not appear to relieve anxiety during the induction of anesthesia (16). We can hypothesize that the clowns have a greater effect than music during induction because they involve the child actively performing gags, which are not standardized but created for every individual child.…”

Clown intervention to reduce preoperative anxiety in children and parents: A randomized controlled trial

“…Due to the lack of variables tested, we cannot assess the relationship. This result supports the conclusions of a Cochrane review, where it appears that the presence of parents during induction of general anesthesia does not reduce children's anxiety (Yip et al, 2009). Furthermore, this finding is consistent with the study of Fernandes and Arriaga (2010) that discovered that the child's emotionality and parental state anxiety associations are not strong enough to predict child worries when considering the relevance of clown intervention.…”

Analysis of Trajectories of Anxiety Behaviors During Induction of Anesthesia in Children With Multiple Encounters: A Secondary Analysis of a Multicenter Retrospective Cohort Study

“…Consistent with previous findings, younger age, autism diagnosis, and PPIA were linked to higher odds of difficult inductions [16]. Children aged 1-12 years showed the greatest reduction in difficult inductions over multiple visits in NORA but not OR environment.…”

Parental presence, clowns or sedative premedication to treat preoperative anxiety in children: what could be the most promising option?

“…These results are consistent also with those of other studies that compare the use of midazolam to alternative interventions for managing preoperative anxiety in children (3,13,16): the results of one of these studies show that music therapy may be helpful on separation and entrance to the OR (depending on the therapist), but it does not appear to relieve anxiety during the induction of anesthesia (16). We can hypothesize that the clowns have a greater effect than music during induction because they involve the child actively performing gags, which are not standardized but created for every individual child.…”

Clown intervention to reduce preoperative anxiety in children and parents: A randomized controlled trial

“…Due to the lack of variables tested, we cannot assess the relationship. This result supports the conclusions of a Cochrane review, where it appears that the presence of parents during induction of general anesthesia does not reduce children's anxiety (Yip et al, 2009). Furthermore, this finding is consistent with the study of Fernandes and Arriaga (2010) that discovered that the child's emotionality and parental state anxiety associations are not strong enough to predict child worries when considering the relevance of clown intervention.…”

Analysis of Trajectories of Anxiety Behaviors During Induction of Anesthesia in Children With Multiple Encounters: A Secondary Analysis of a Multicenter Retrospective Cohort Study

“…Consistent with previous findings, younger age, autism diagnosis, and PPIA were linked to higher odds of difficult inductions [16]. Children aged 1-12 years showed the greatest reduction in difficult inductions over multiple visits in NORA but not OR environment.…”