Pre‐induction behaviour of children A review of placebo‐controlled trials of sedatives

Morgan‐Hughes, J. O.; Bangham, Jenny

doi:10.1111/j.1365-2044.1990.tb14326.x

Cited by 12 publications

(2 citation statements)

References 31 publications

(2 reference statements)

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“…Several studies [2][3][4][11][12][13] report a number of benefits of premedication when compared to placebo, such as (a) decreased preoperative anxiety, psychological trauma, and stress response; (b) better anesthesia induction with lower incidence of desaturation; and (c) lower frequency of postoperative behavioral disturbances. On the other hand, some authors [5,6,[14][15][16] have questioned this point of view and report that premedication was found to be no better than saline, suggesting that the evidence of benefit is not strong enough to justify studies without placebo control. Furthermore, premedication may yield side effects and complications [5,6,17] (e.g., deep sedation, respiratory depression, paradoxical agitation, vomiting), requiring an investigation of the best compromise between advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 96%

Comparison between ketamine and fentanyl–droperidol for rectal premedication in children: a randomized placebo controlled trial

Zanette

Micaglio

Zanette³

et al. 2010

J Anesth

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Section: Discussionmentioning

confidence: 96%

Comparison between ketamine and fentanyl–droperidol for rectal premedication in children: a randomized placebo controlled trial

Zanette

Micaglio

Zanette³

et al. 2010

J Anesth

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“…Psychological trauma and anxiety caused by maternal deprivation are the major challenges in paediatric anaesthesia. 1,2 Preoperative anxiety often can lead to negative responses postoperatively which is displayed several ways including difficulty accepting anaesthesia masks or difficulty separating from parents.…”

Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of intranasal dexmedetomidine dosing as premedication in paediatric surgery: Randomized controlled trial

Agrawal,

Bhuwania

2023

IJCA

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: The use of alpha 2 agonists are now becoming the standard of care pre-medication drug in paediatric patients to induce induction and reduce separation anxiety. A prospective, randomized, double-blind, controlled study was designed to assess and compare the effectiveness and safety of two different strengths of intranasal dexmedetomidine in children between the ages of 2 and 8.: Sixty children between ages 2-8 years and of ASA physical status I or II scheduled for elective surgery were randomly assigned to one of two groups. Group A received 1 µg/kg of intranasal dexmedetomidine while Group B received 2 µg/kg as pre-medication. Patients sedation status, behaviour (mask acceptance) and parental separation scores were assessed over 30 min as primary endpoints along with its effect on haemodynamic and respiratory parameters over the same duration as secondary endpoints.: 7.4% of children in group A while 96.5% of children in group B achieved a satisfactory sedation score, 11.1% of children in group A while 100% of children in group B achieved a satisfactory mask acceptance score and 7.4% of children in group A while 100% of children in group B achieved a satisfactory parent child separation score (p<0.001). We did not observe any clinically significant effects of dexmedetomidine on RR, SpO2, HR or MAP and no child required atropine or supplemental oxygen.: We conclude that 2µg/kg dose as compared to 1µg/kg offers multiple advantages of being good sedative, analgesic and anxiolytic in this age group when used as pre-medication.

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Preparing children for the operating room: psychological issues

McGraw

1994

Can J Anaesth

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Childhood disease can be viewed in a psychosocial as well as a biologic context. Indeed, for many elective paediatric surgical procedures, the attendant psychological disruption appears to match or surpass the pathophysiological insult. Familiarity with developmental theories and psychological studies of hospitalization and anaesthesia in children can help one to recognize how different children cope with anxiety and respond to the stresses of hospital care. With this knowledge, the practitioner can prepare children for surgery more effectively and anticipate postoperative behavioural disturbances. This article reviews theories of personality development as well as psychological studies of hospitalization and anaesthesia in children. It then discusses parental presence during induction of anaesthesia and sedative premeditation. General issues regarding communication with children and their parents are discussed. Finally, specific strategies for preparing the environment, preparing the parents, and preparing the child for the operating room are discussed. Models of personality developmentPersonality can be defined as the organization of psychophysical systems within the individual that determine his or her unique adjustments to the environment, i Various features of personality theories can be used in attempting to understand how children of different ages respond to stress. With increased understanding of age-

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Pre‐induction behaviour of children A review of placebo‐controlled trials of sedatives

Cited by 12 publications

References 31 publications

Comparison between ketamine and fentanyl–droperidol for rectal premedication in children: a randomized placebo controlled trial

Comparison between ketamine and fentanyl–droperidol for rectal premedication in children: a randomized placebo controlled trial

Comparative effectiveness of intranasal dexmedetomidine dosing as premedication in paediatric surgery: Randomized controlled trial

Preparing children for the operating room: psychological issues

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