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Parental Presence (parental + presence)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Parental presence during induction enhances the effect of oral midazolam on emergence behavior of children undergoing general anesthesia

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2007
Y.-C. P. Arai
Background:, Pre-anesthetic anxiety and emergence agitation are major challenges for anesthesiologists in pediatric anesthesia. Thus, sedative premedication and parental presence during induction of anesthesia (PPIA) are used to treat pre-anesthetic anxiety in children. The aim of the present study was to test if a combination of mother presence and midazolam premedication is effective for improving emergence condition in children undergoing general anesthesia. Methods:, Sixty children were allocated to one of three groups: a sedative group (0.5 mg/kg oral midazolam), a PPIA group or a sedative and PPIA group. When anesthesia was induced with 7% sevoflurane in 100% oxygen, qualities of mask induction were rated. Anesthesia was maintained with sevoflurane (1.5,2.5%) in 60% oxygen and intravenous fentanyl 4 ,g/kg. During emergence from anesthesia, the score of the child's emergence behavior was rated. Results:, The children in the midazolam group showed a better quality of mask induction compared with those in the PPIA group, the addition of parental presence to oral midazolam did not provide additional improvement of mask induction. In contrast, the children in the midazolam + PPIA group were less agitated than those in the other groups at emergence from anesthesia. Conclusion:, Parental presence during induction of anesthesia enhanced the effect of oral midazolam on emergence behavior of children undergoing general anesthesia. [source]

Preoperative information needs of children undergoing tonsillectomy

JOURNAL OF CLINICAL NURSING, Issue 19-20 2010
Aoife Buckley
Aims and objectives., To identify the information needs of children undergoing tonsillectomy with reference to content of information, method of delivery, information providers and timing of information provision. Background., Tonsillectomy can be anxiety provoking for children and preoperative preparation programmes are long recognised to reduce anxiety. However, few have been designed from the perspectives of children and to date little is known about how best to prepare children in terms of what to tell them, how to convey information to them, who can best provide information and what is the best timing for information provision. Design., A qualitative descriptive study. Method., Data were collected from nine children (aged 6,9) using interviews supported by a write and draw technique. Data were coded and categorised into themes reflecting content, method, providers and timing of information. Results., Children openly communicated their information needs especially on what to tell them to expect when facing a tonsillectomy. Their principal concerns were about operation procedures, experiencing ,soreness' and discomfort postoperatively and parental presence. Mothers were viewed as best situated to provide them with information. Children were uncertain about what method of information and timing would be most helpful to them. Conclusion., Preoperative educational interventions need to take account of children's information needs so that they are prepared for surgery in ways that are meaningful and relevant to them. Future research is needed in this area. Relevance to clinical practice., Practical steps towards informing children about having a tonsillectomy include asking them what they need to know and addressing their queries accordingly. Child-centred information leaflets using a question and answer format could also be helpful to children. [source]

Parental presence during induction enhances the effect of oral midazolam on emergence behavior of children undergoing general anesthesia

Preparation of parents by teaching of distraction techniques does not reduce child anxiety at anaesthetic induction.

PEDIATRIC ANESTHESIA, Issue 9 2002
A. Watson
Introduction For those children having surgery, induction of anaesthesia is one of the most stressful procedures the child experiences perioperatively. Current work has failed to show a benefit of parental presence at induction of anaesthesia for all children. The reasons for lack of effect may include the high anxiety levels of some parents and also that the role for parents at their child's induction is not delineated. The main aim of this study was to see if parental preparation by teaching of distraction techniques could reduce their child's anxiety during intravenous induction of anaesthesia. Methods After ethics committee approval 40 children aged 2,10 years old, ASA status I or II undergoing daycase surgery under general anaesthesia were enrolled into the study. To avoid possible confounding factors children with a history of previous, surgery, chronic illness or developmental delay were excluded form participation. No children were given sedative premedication. After written informed consent by the parent, each child and parent was randomly assigned to an intervention or control group. Parents in the intervention group received preparation from a play specialist working on the children's surgical ward. It involved preparation for events in the anaesthetic room and instruction on methods of distraction for their child during induction using novel toys, books or blowing bubbles appropriate to the child's age. Preoperative information collected included demographic and baseline data. The temperament of the child was measured using the EASI (Emotionality, Activity, Sociability, Impulsivity) instrument of child temperament(l). In the anaesthetic room all children were planned to have intravenous induction of anaesthesia after prior application of EMLA cream. Anxiety of the child was measured by the modified Yale Preoperative Anxiety Scale (mYPAS)(2) by a blinded independent observer at three time points: entrance to the anaesthetic room, intravenous cannulation and at anaesthesia induction. Cooperation of the child was measured by the Induction Compliance Checklist (ICC) by the same observer (3). Postoperative data collected included parental satisfaction and anxiety scores measured by the Stait Trait Anxiety Inventory (STAI)(4) and at one week the behaviour of the child was measured Using the Posthospitalisation Behavioural Questionnaire (PHBQ)(5). Normally distributed data were analysed by a two-sample t-test, categorical data by Pearson's Chi-squared test and non-parametric data by the Wilcoxon rank-sum test. Results One parent withdrew after enrolment. This left 22 children in the control group and 17 in the intervention group. There were no significant differences in demographic and baseline data of the children between the two groups including ethnic origin, number of siblings, birth order of the child, recent stressful events in the child's life, previous hospital admissions and the temperament of the child. Parent demographics were also similar between groups including parent's age, sex, relationship to child and level of education. There were no significant differences in child anxiety or cooperation during induction measured by mYPAS and ICC between the control and intervention groups. More parents in the preparation group distracted their child than those without preparation but this did not reach significance. Parental anxiety immediately postinduction was similar between groups as was the level of parental satisfaction. The incidence of development of new negative postoperative behaviour of the child at one week was not significantly different between groups. Discussion This study shows that giving an active role for parents in the induction room, particularly by instructing them on distracting techniques for their child, does not reduce their child's anxiety compared to conventional parental presence. We conclude resources should not be directed at this type of parental preparation. Further work should examine the usefulness of distraction by nursing staff or play specialists during anaesthetic induction. [source]