Journal of Anesthesia & Clinical Care Category: Clinical Type: Review Article
Preparation for General Anesthesia in Children
- Rosy Kim1, Robert Karpinos1, Maroje Turk2*
- 1 St Barnabas Health System, Bronx, New York, United States
- 2 Department Of Anesthesiology, St Barnabas Health System, Pennsylvania, United States
*Corresponding Author:Maroje Turk
Department Of Anesthesiology, St Barnabas Health System, Pennsylvania, United States
Received Date: Aug 01, 2019 Accepted Date: Aug 15, 2019 Published Date: Aug 22, 2019
TRADITIONAL PHARMACOLOGICAL INTERVENTION
PARENTS INVOLVEMENT TECHNIQUES
Parental presence during induction technique
Family-centered preparation for surgery
In-hospital preparation video
At-home preparation video
NEWEST TREND: DISTRACTION TECHNOLOGY
Cognitive engagement with video games has been shown to achieve superior anxiolysis as compared with midazolam and parental presence. In a study done by Patel et al., 112 children aged 4-12 years were randomly divided into three groups: Parent Presence (PP), PP+ a hand held video game, and PP+0.5mg/kg oral midazolam (M) given 20 minutes before entering the operating room . The results show that there was a significant increase in anxiety in group M and PP at induction of anesthesia compared with baseline, but not in video game group. Instead, a video game group demonstrated a decrease in anxiety from baseline, significantly different compared with parent presence group. A hand held video game is a low cost, portable, and easy to implement method to provide anxiolysis to pediatric patients .
Smartphone game application
Despite this drawback, SM group found to be the most effective anxiety reducer followed by smart phone group (S group) then midazolam group (M group) as the last. The Smartphone is an effective alternative to premedication for anti anxiety that can tailor to children’s individual characteristics . Thus, interactive games appear to be more effective than parental presence or midazolam alone in reducing anxiety in children.
Video (YouTube) clips
- Rosenbaum A, Kain ZN, Larsson P, Lönnqvist PA, Wolf AR (2009) The place of premedication in pediatric practice. Pediatric Anesthesia 19: 817-828.
- Kar SK, Ganguly T, Dasgupta CS, Goswami A (2015) Preoperative Anxiety in Pediatric Population: Anesthesiologist’s Nightmare. Translational Biomedicine 6: 4.
- Almenrader N, Passariello M, Coccetti B, Haiberger R, Pietropaoli P (2007) Premedication in Children: a Comparison of Oral Midazolam and Oral Clonidine. Paediatr Anaesth 17: 1143-1149.
- Coté CJ (1999) Preoperative preparation and premedication. Br J Anaesth 83: 16-28.
- Kain ZN, Caldwell-Andrews AA, Mayes LC, Weinberg ME, Wang SM, et al. (2007) Family-centered preparation for surgery improves perioperative outcomes in children: a randomized controlled trial. Anesthesiology 106: 65-74.
- Karabulut N, Duygu Ar (2009) The Effect of Different Training Programs Applied Prior to Surgical Operation on Anxiety Levels. Semantic Scholar 47: 2.
- Wakimizu R, Kamagata S, Kuwabara T, Kamibeppu K (2009) A randomized controlled trial of an at-home preparation programme for Japanese preschool children: effects on children's and caregivers' anxiety associated with surgery. J Eval Clin Pract 15: 393-401.
- Patel A, Schieble T, Davidson M, Tran MC, Schoenberg C, et al. (2006) Distraction with a hand-held video game reduces pediatric preoperative anxiety. Paediatr Anaesth 16: 1019-1027.
- Lee JH, Jung HK, Lee GG, Kim HY, Park SG, et al. (2013) Effect of behavioral intervention using smartphone application for preoperative anxiety in pediatric patients. Korean J Anesthesiol 65: 508-518.
- Mifflin KA, Hackmann T, Chorney JM, et al. (2012) Streamed video clips to reduce anxiety in children during inhaled induction of anesthesia. Anesth Analg 115: 1162-1167.
- Kain ZN, Caldwell-Andrews AA, Wang SM, Krivutza DM, Weinberg ME, et al. (2003) Parental intervention choices for children undergoing repeated surgeries. Anesth Analg 96: 970-975.
- Kerimoglu B, Neuman A, Paul J, Stefanov DG, Twersky R (2013) Anesthesia induction using video glasses as a distraction tool for the management of preoperative anxiety in children. Anesth Analg 117: 1373-1379.
- Berghmans J, Weber F, van Akoleyen C, Utens E, Adriaenssens P, et al. (2012) Audiovisual aid viewing immediately before pediatric induction moderates the accompanying parents' anxiety. Paediatr Anaesth 22: 386-392.
Citation:Kim R, Karpinos R, Turk M (2019) Preparation for General Anesthesia in Children. J Anesth Clin Care 6: 40.
Copyright: © 2019 Rosy Kim, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.