Julie Hilly1,2, Anne-Laure Hörlin1,2, Joelle Kinderf1, Cecile Ghez1, Sabrina Menrath2,3, Honorine Delivet4,5, Christopher Brasher1, Yves Nivoche1,2, Souhayl Dahmani1,2,6. 1. Department of Anesthesia, Intensive care, Robert Debré University Hospital, Paris Diderot University, Paris, France. 2. Denis Diderot University, Paris, France. 3. Department of Peadiatric Orthopedics, RobertDebré University Hospital, Paris Diderot University, Paris, France. 4. Department of Pain Management, Robert Debré University Hospital, Paris Diderot University, Paris, France. 5. René Descarte University, Paris, France. 6. DHU PROTECT INSERM U 1141, Robert Debré University Hospital, Paris, France.
Abstract
INTRODUCTION: Postoperative maladaptive behaviors (POMBs) are common following pediatric anesthesia, and preoperative anxiety is associated with POMBs. A family-centered preoperative preparation workshop was instituted with the aim of reducing the incidence of POMB and preoperative anxiety, and the study was constructed to evaluate its effectiveness. MATERIAL AND METHODS: A prospective cohort study was constructed, comparing patients who attended the workshop (workshop group) with patients who did not attend and who were matched for age and type of surgery (comparison group). Preoperative anxiety was measured using the mYPAS score, postoperative emergence agitation (EA) was measured using the PAED score, POMBs were assessed with the Post-Hospital Behavior Questionnaire (PHBQ) on postoperative day 7, and PACU morphine consumption and PACU length of stay were recorded. Statistical analysis was performed employing the X² test, the Fisher's exact test, and the Mann-Whitney test as appropriate. Data were expressed as median [minimum, maximum]. RESULTS: Fifty-six patients from 3 to 18 years of age were recruited. Twenty-seven patients in the workshop group were compared to 26 in the comparison group, after exclusions for missing data. Significant differences were demonstrated between groups for POMBs intensity (PHBQ score 2 [0; 9] vs 5 [0; 10], P = 0.008) and incidence (PHBQ score >6: 3.6% vs 35.7%, P = 0.003), and for mYPAS score (28 [23; 87] vs 37 [23;100], P = 0.015). No difference was found for EA, PACU morphine consumption, or PACU length of stay. CONCLUSION: The workshop appears to result in reduced preoperative anxiety and POMBs.
INTRODUCTION:Postoperative maladaptive behaviors (POMBs) are common following pediatric anesthesia, and preoperative anxiety is associated with POMBs. A family-centered preoperative preparation workshop was instituted with the aim of reducing the incidence of POMB and preoperative anxiety, and the study was constructed to evaluate its effectiveness. MATERIAL AND METHODS: A prospective cohort study was constructed, comparing patients who attended the workshop (workshop group) with patients who did not attend and who were matched for age and type of surgery (comparison group). Preoperative anxiety was measured using the mYPAS score, postoperative emergence agitation (EA) was measured using the PAED score, POMBs were assessed with the Post-Hospital Behavior Questionnaire (PHBQ) on postoperative day 7, and PACUmorphine consumption and PACU length of stay were recorded. Statistical analysis was performed employing the X² test, the Fisher's exact test, and the Mann-Whitney test as appropriate. Data were expressed as median [minimum, maximum]. RESULTS: Fifty-six patients from 3 to 18 years of age were recruited. Twenty-seven patients in the workshop group were compared to 26 in the comparison group, after exclusions for missing data. Significant differences were demonstrated between groups for POMBs intensity (PHBQ score 2 [0; 9] vs 5 [0; 10], P = 0.008) and incidence (PHBQ score >6: 3.6% vs 35.7%, P = 0.003), and for mYPAS score (28 [23; 87] vs 37 [23;100], P = 0.015). No difference was found for EA, PACUmorphine consumption, or PACU length of stay. CONCLUSION: The workshop appears to result in reduced preoperative anxiety and POMBs.
Authors: Bryan K Lao; Zeev N Kain; Dina Khoury; Brooke N Jenkins; Jeremy Prager; Robert S Stevenson; Brenda Golianu; Jeannie Zuk; Jeffrey I Gold; Qiu Zhong; Michelle A Fortier Journal: Int J Pediatr Otorhinolaryngol Date: 2020-05-11 Impact factor: 1.675