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Emergence Behavior (emergence + behavior)

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Medical Sciences100%

Selected Abstracts

Induction and emergence behavior of children undergoing general anesthesia correlates with maternal salivary amylase activity before the anesthesia

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2008
Y.-C. P. ARAI
Background: The parents of the children who undergo surgery experience stress during the pre-anesthetic period. Such stress influences the mental status of their children, thereby inducing their pre-anesthetic anxiety and problematic behavior at emergence. Recently, measurement of salivary biomarkers was evaluated as stress biomarkers. Especially, ,-amylase is utilized as an excellent index for psychological stress. In the present study, we tested whether salivary amylase activity of mothers before the surgery of their children correlates with the peri-operative children's behaviors. Methods: A total of 22 pairs of mothers and children were analyzed. Maternal salivary amylase activity was evaluated at the entrance of the operation room. The children underwent minor plastic surgery under general anesthesia, and induction and emergence behaviors were assessed. Results: The higher the maternal salivary amylase activity, the severer the children's induction anxiety (rs=,0.667, n=22, P<0.0001), and the higher the maternal amylase activity, the severer the children's emergence agitation (rs=0.705, n=22, P<0.0001). Conclusion: Induction and emergence behaviors of children undergoing general anesthesia significantly correlated with their respective maternal salivary amylase activity during the pre-anesthetic period. [source]

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]

Comparison of a combination of midazolam and diazepam and midazolam alone as oral premedication on preanesthetic and emergence condition in children

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2005
Y-C. P. Arai
Background:, Preanesthetic anxiety and emergence agitation are major challenges for anesthesiologists in pediatric anesthesia. Thus, midazolam has been used as premedication for children. However, midazolam alone is not effective for emergence agitation. The present study tested the effect of a combination of midazolam and diazepam on the preanesthetic condition and emergence behavior in children. Methods:, Forty-two children were allocated to one of three groups: the NoPre group received no premedication; the Mi group received midazolam 0.5 mg kg,1 orally; and the Mi + Di group received midazolam 0.25 mg kg,1 and diazepam 0.25 mg kg,1 orally. When anesthesia was induced with 7% sevoflurane in 100% oxygen, qualities of mask induction and sedation were rated. Anesthesia was maintained with sevoflurane (3,5%) in 100% oxygen. During emergence from anesthesia, the score of the child's emergence behavior was rated. Results:, Children in the Mi and Mi + Di groups were more sedated than those in the NoPre group. A combination of midazolam and diazepam provided a better quality of mask induction, when compared with no premedication. Also, the children in the Mi + Di group were less agitated than those in the other groups during the emergence. Conclusion:, Children in the Mi + Di group were significantly more sedated at induction of anesthesia and less agitated during emergence from anesthesia. [source]

Induction and emergence behavior of children undergoing general anesthesia correlates with maternal salivary amylase activity before the anesthesia

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2008
Y.-C. P. ARAI
Background: The parents of the children who undergo surgery experience stress during the pre-anesthetic period. Such stress influences the mental status of their children, thereby inducing their pre-anesthetic anxiety and problematic behavior at emergence. Recently, measurement of salivary biomarkers was evaluated as stress biomarkers. Especially, ,-amylase is utilized as an excellent index for psychological stress. In the present study, we tested whether salivary amylase activity of mothers before the surgery of their children correlates with the peri-operative children's behaviors. Methods: A total of 22 pairs of mothers and children were analyzed. Maternal salivary amylase activity was evaluated at the entrance of the operation room. The children underwent minor plastic surgery under general anesthesia, and induction and emergence behaviors were assessed. Results: The higher the maternal salivary amylase activity, the severer the children's induction anxiety (rs=,0.667, n=22, P<0.0001), and the higher the maternal amylase activity, the severer the children's emergence agitation (rs=0.705, n=22, P<0.0001). Conclusion: Induction and emergence behaviors of children undergoing general anesthesia significantly correlated with their respective maternal salivary amylase activity during the pre-anesthetic period. [source]

Emergence agitation after cataract surgery in children: a comparison of midazolam, propofol and ketamine

PEDIATRIC ANESTHESIA, Issue 9 2010
JIAYAO CHEN MD
Summary Objectives:, The aim of this study was to determine whether the concurrent use of either of a subhypnotic dose of midazolam, propofol or ketamine with fentanyl just before discontinuing the sevoflurane anesthesia would effectively sedate the children as they recovered and significantly decrease the incidence and severity of emergence agitation and would not delay patient awakening and discharge. Background:, Postoperative emergence agitation may occur in children after general anesthesia with volatile anesthetics. Children who undergo cataract surgery after sevoflurane induction and sevoflurane,remifentanil maintenance may experience this type of agitation. Methods/Materials:, In 120 un-premedicated children aged 1,7 years, mask induction with sevoflurane was performed and they were then randomly assigned to one of the three antiagitation postoperative groups (n = 40). We studied the postoperative antiagitation effects of subhypnotic doses of midazolam combined with fentanyl, propofol with fentanyl or ketamine with fentanyl administered just before discontinuing the sevoflurane anesthesia. A score for the level of agitation can be assigned based on the recovery mental state (RMS) scale and the recently published pediatric anesthesia emergence delirium scale (PAED). Postoperative factors assessed included emergence behaviors, the time to eye opening, the time to discharge from the postanesthesia care unit (PACU) to the ward. Results:, There were significantly more agitated children in the ketamine-group when compared to the midazolam-group or to the propofol-group at all time P < 0.05), especially at 10 and 15 min. The PAED scale showed a significant advantage for midazolam,fentanyl [5 (2,15)] and propofol,fentanyl [6 (3,15)] versus ketamine,fentanyl [10 (3,20)] (P < 0.05). The time to discharge from the PACU to the ward was not significantly different among the groups. Conclusions:, Intravenous administration of a subhypnotic dose of midazolam or propofol in addition to a low dose of fentanyl just before discontinuing the sevoflurane anesthesia was both effective on decreasing the incidence and severity of emergence agitation in children undergoing cataract extraction without significant delaying recovery time and discharge. The effect of midazolam was clearer than that seen with propofol. [source]