Randomized-controlled trial of parent-led exposure to anesthetic mask to prevent child preoperative anxiety

• Published in: Canadian journal of anesthesia 2019-03, Vol.66 (3), p.293-301
• Main Authors: Walker, Kirstie L., Wright, Kristi D., Raazi, Mateen
• Format: Article
• Language: English
• Subjects: Adult; Ambulatory Surgical Procedures - psychology; Anesthesia; Anesthesia - methods; Anesthesia - psychology; Anesthesia, Inhalation - instrumentation; Anesthesiology; Anesthetics - administration & dosage; Anxiety; Anxiety - prevention & control; Cardiology; Child; Child, Preschool; Critical Care Medicine; Female; Humans; Intensive; Male; Masks; Medicine; Medicine & Public Health; Middle Aged; Pain Medicine; Parents; Pediatrics; Pneumology/Respiratory System; Preoperative Care - methods; Preoperative Care - psychology; Reports of Original Investigations; Surgery
• ISSN: 0832-610X; 1496-8975
• DOI: 10.1007/s12630-018-01274-8

Purpose To examine the efficacy of parent-directed anesthetic mask exposure and shaping practice to prevent child preoperative anxiety, with a specific focus on timing of exposure. Methods This randomized-controlled trial included 110 children ages four to seven years undergoing day surgery dental procedures and their parents. Families were randomly assigned to one of three groups: 1) parent-directed mask exposure/shaping practice at least three times in the week prior to surgery (Group 1); 2) parent-directed mask exposure/shaping practice at least once on the day of surgery (Group 2); 3) no exposure prior to induction (Group 3). Child anxiety was observer-rated using the modified Yale Preoperative Anxiety Scale during the day surgery experience, and induction compliance was observer-rated using the Induction Compliance Checklist. Results Results demonstrated significant differences in observer-rated child anxiety at anesthetic induction across groups. Group 2 demonstrated significantly lower observer-rated anxiety than Group 3 with a medium effect, F (1, 71) = 4.524, P = 0.04, η p 2 = 0.06. A significant interaction was observed between these two groups over time (i.e., admission to anesthesia induction), F (1, 71) = 4.365, P = 0.04, η p 2 = 0.06 (i.e., small to medium effect). Group 2 demonstrated the best anesthesia induction compliance (i.e., significantly lower scores than Group 3, P = 0.04). Conclusion Timing of the delivery of mask exposure (i.e., on the day of surgery) to address child preoperative anxiety and induction compliance in the day surgery setting may be an important consideration. The current results inform the integration of this simple, effective strategy into practice.