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Bolt R, Hyslop MC, Herbert E, Papaioannou DE, Totton N, Wilson MJ, Clarkson J, Evans C, Ireland N, Kettle J, Marshman Z, Norrington AC, Paton RH, Vernazza C, Deery C. The MAGIC trial: a pragmatic, multicentre, parallel, noninferiority, randomised trial of melatonin versus midazolam in the premedication of anxious children attending for elective surgery under general anaesthesia. Br J Anaesth 2024; 132:76-85. [PMID: 37953202 PMCID: PMC10797512 DOI: 10.1016/j.bja.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Child anxiety before general anaesthesia and surgery is common. Midazolam is a commonly used premedication to address this. Melatonin is an alternative anxiolytic, however trials evaluating its efficacy in children have delivered conflicting results. METHODS This multicentre, double-blind randomised trial was performed in 20 UK NHS Trusts. A sample size of 624 was required to declare noninferiority of melatonin. Anxious children, awaiting day case elective surgery under general anaesthesia, were randomly assigned 1:1 to midazolam or melatonin premedication (0.5 mg kg-1, maximum 20 mg) 30 min before transfer to the operating room. The primary outcome was the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF). Secondary outcomes included safety. Results are presented as n (%) and adjusted mean differences with 95% confidence intervals. RESULTS The trial was stopped prematurely (n=110; 55 per group) because of recruitment futility. Participants had a median age of 7 (6-10) yr, and 57 (52%) were female. Intention-to-treat and per-protocol modified Yale Preoperative Anxiety Scale-Short Form analyses showed adjusted mean differences of 13.1 (3.7-22.4) and 12.9 (3.1-22.6), respectively, in favour of midazolam. The upper 95% confidence interval limits exceeded the predefined margin of 4.3 in both cases, whereas the lower 95% confidence interval excluded zero, indicating that melatonin was inferior to midazolam, with a difference considered to be clinically relevant. No serious adverse events were seen in either arm. CONCLUSION Melatonin was less effective than midazolam at reducing preoperative anxiety in children, although the early termination of the trial increases the likelihood of bias. CLINICAL TRIAL REGISTRATION ISRCTN registry: ISRCTN18296119.
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Affiliation(s)
- Robert Bolt
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Marie C Hyslop
- Sheffield Clinical Trials Research Unit, ScHARR, University of Sheffield, Sheffield, UK
| | - Esther Herbert
- Sheffield Clinical Trials Research Unit, ScHARR, University of Sheffield, Sheffield, UK
| | - Diana E Papaioannou
- Sheffield Clinical Trials Research Unit, ScHARR, University of Sheffield, Sheffield, UK
| | - Nikki Totton
- Sheffield Clinical Trials Research Unit, ScHARR, University of Sheffield, Sheffield, UK
| | - Matthew J Wilson
- Sheffield School of Health & Related Research, University of Sheffield, Sheffield, UK
| | - Janet Clarkson
- Dundee Dental Hospital and School, University of Dundee, Dundee, UK
| | - Christopher Evans
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Nicholas Ireland
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jennifer Kettle
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | | | | | - Christopher Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
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The calming effect of roasted coffee aroma in patients undergoing dental procedures. Sci Rep 2021; 11:1384. [PMID: 33446795 PMCID: PMC7809118 DOI: 10.1038/s41598-020-80910-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 12/30/2020] [Indexed: 12/25/2022] Open
Abstract
Coffee beverage consumption is well-known to exert various health benefits; however, the effects of coffee aroma are rarely explored. This study aimed to investigate the calming effect of inhaling coffee aroma while the patients underwent dental procedures (probing and scaling). Salivary α-amylase (sAA) and cortisol (sCort) levels were measured as proxies of sympathetic nervous system and hypothalamic–pituitary–adrenal axis responses to stress respectively. Blood pressures and pulse rates were recorded. The results showed that undergoing dental procedures could increase sAA and sCort levels of the patients inhaling sham aroma while those inhaling coffee aroma had significantly decreased sAA and sCort levels (40% and 25% differences, respectively). The pulse rates of those inhaling coffee aroma were also lower. Subjective assessment using visual analog scale was in line with objective measures as well. The preference for coffee aroma or the frequency of coffee drinking had no effect on the sAA and sCort responses. This is the first study to provide evidence on the effect of coffee aroma on sAA and sCort levels in patients undergoing dental procedures.
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Anxiety level and risk factors among pediatric patients in endoscopic procedures outside the operating room: A cross-sectional study. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.775935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Exploring Non-Pharmacological Management among Anesthesia Providers to Reduce Preoperative Distress in Children. J Pediatr Nurs 2020; 50:105-112. [PMID: 31805493 DOI: 10.1016/j.pedn.2019.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 11/23/2022]
Abstract
Preparation for surgery with the induction of general anesthesia is one of the most stressful events that a child can experience. It produces several threats to the child, including physical harm, parent separation, and fear of the unknown. Anesthesia providers utilize non-pharmacological and pharmacological interventions to decrease this preoperatively. However, little is known about the non-pharmacological interventions utilized by anesthesia providers in practice. The purpose of this study was to explore non-pharmacological interventions utilized by anesthesia providers before and during the induction of general anesthesia to reduce preoperative distress in children ages one to six years old. A qualitative descriptive approach was used in this study. Twenty anesthesia providers, fourteen registered nurse anesthetists and six anesthesiologists, participated in face to face, in-depth interviews in South Florida. Content analysis was used to identify and define the major themes that emerged from the interviews. A total of seven main themes were identified. Only the three themes directly related to parent-provider-child relationship are discussed in this paper: (I) Communication, (II) Observational Skills, and (III) Parental Presence. The anesthesia providers who participated in this study offered an opportunity to better understand the non-pharmacological interventions used to impact the management of preoperative distress among children. Study findings provide evidence about non-pharmacological anesthesia providers' clinical work not found elsewhere in the literature. Non-pharmacological interventions are effective in reducing preoperative distress in children.
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Kumar A, Das S, Chauhan S, Kiran U, Satapathy S. Perioperative Anxiety and Stress in Children Undergoing Congenital Cardiac Surgery and Their Parents: Effect of Brief Intervention—A Randomized Control Trial. J Cardiothorac Vasc Anesth 2019; 33:1244-1250. [DOI: 10.1053/j.jvca.2018.08.187] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Indexed: 11/11/2022]
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Waseem H, Mazzamurro RS, Fisher AH, Bhowmik S, Zaman RA, Andrew A, Bauer DF. Parental satisfaction with being present in the operating room during the induction of anesthesia prior to pediatric neurosurgical intervention: a qualitative analysis. J Neurosurg Pediatr 2018; 21:528-534. [PMID: 29424629 DOI: 10.3171/2017.10.peds17261] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Parental presence in the operating room during the induction of anesthesia (PPIA) has been shown to decrease parent and child anxiety and increase satisfaction with patient experience in outpatient otolaryngological procedures, such as tympanostomy tube placement. PPIA for other procedures, such as a major neurosurgical intervention, has been a practice at the authors' institutions for many years. This practice is not universally accepted across the United States, and the potential benefits for patients and families have not been formally evaluated. The aim of this study is to provide a qualitative analysis of parental and patient satisfaction with PPIA at the authors' institution. METHODS All patients younger than 18 years who underwent surgical intervention at the authors' institution between August 2013 and December 2015 were identified. All surgeries were performed by a single neurosurgeon. A random sample of 96 parents were contacted by telephone for a qualitative, semiscripted interview; 42 parents completed the interviews. The interview consisted of a validated satisfaction assessment in addition to a standardized open-ended questionnaire. Thematic analysis was performed until saturation was achieved, and responses were coded into the predominant themes. Member checking was performed, and a thick description was created. RESULTS The predominant themes identified with PPIA were 1) perception of induction as traumatizing or distressing to witness, 2) positive feelings regarding having been present, 3) satisfaction regarding the overall experience with surgery, 4) variable feelings in parents who decided not to attend induction, and 5) mixed feelings in the interactions with the care team. Parents expressed an array of positive, negative, and neutral impressions of the experience; however, overall, most experiences were positive. Most parents would choose PPIA again if their child required additional surgery. CONCLUSIONS This is the first study to evaluate the benefit of PPIA for pediatric neurosurgical patients. The results show a unique insight into medical communication and patient satisfaction with high-risk surgeries. PPIA may be able to help shape an environment of trust and increase satisfaction with perioperative care.
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Affiliation(s)
| | - Rachael S Mazzamurro
- 2Division of Neurosurgery, Department of Surgery, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Alec H Fisher
- 2Division of Neurosurgery, Department of Surgery, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Subasish Bhowmik
- 2Division of Neurosurgery, Department of Surgery, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Rifat A Zaman
- 2Division of Neurosurgery, Department of Surgery, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Angeline Andrew
- 1Department of Neurology.,2Division of Neurosurgery, Department of Surgery, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - David F Bauer
- 3Division of Neurosurgery, Department of Surgery; and.,4Department of Pediatrics, Dartmouth-Hitchcock Medical Center; and
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Cui X, Zhu B, Zhao J, Huang Y, Luo A, Wei J. Parental state anxiety correlates with preoperative anxiety in Chinese preschool children. J Paediatr Child Health 2016; 52:649-55. [PMID: 27144949 DOI: 10.1111/jpc.13176] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 10/10/2015] [Accepted: 02/01/2016] [Indexed: 12/01/2022]
Abstract
AIM Preoperative anxiety in children is largely dependent on age and is influenced by anxiety level in parents. The current study compared the level of preoperative anxiety in preschool children versus school-aged children and its relationship with the state and trait anxiety of the parents. METHODS This study included 54 preschool children (2-5 years of age) and 48 school-age children (6-12 years) scheduled to receive ear, nose and throat, plastic or ophthalmologic surgeries. Preoperative anxiety of children was assessed in the holding area immediately prior to the surgery using a modified Yale Preoperative Anxiety Scale (m-YPAS). Compliance with anaesthesia induction was assessed using an Induction Compliance Checklist (ICC). The state and trait anxiety of the parent who accompanied the child was assessed using a State-Trait Anxiety Inventory (STAI) questionnaire. RESULTS Both m-YPAS and ICC scores were higher in preschool children than in school-age children with significant correlation between the two measures. The STAI-S score of parents was higher in the preschool group than in the school-age group. No significant difference was found in STAI-T score between the two age groups. Children's m-YPAS score correlated with parental STAI-T score in both groups (rho = 0.297, P = 0.029 and rho = 0.338, P = 0.019, respectively) but only with STAI-S score in the preschool group (rho = 0.400, P = 0.003). CONCLUSIONS Both preschool children and their parents are more anxious than school-age dyads prior to surgery. The anxiety level of the children correlates with state anxiety of the parents in preschool children but not in school-age children.
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Affiliation(s)
- Xulei Cui
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Zhu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Zhao
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuguang Huang
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ailun Luo
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Martin S, Smith AB, Newcomb P, Miller J. Effects of therapeutic suggestion under anesthesia on outcomes in children post tonsillectomy. J Perianesth Nurs 2015; 29:94-106. [PMID: 24661479 DOI: 10.1016/j.jopan.2013.03.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 02/27/2013] [Accepted: 03/30/2013] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Tonsillectomy causes discomfort in children. Positive therapeutic suggestions (TS) may be given to patients while they are emerging from general anesthesia as a potential tool to decrease distress. PURPOSE This study examined impact of TS on outcomes, when delivered to children emerging from general anesthesia post tonsillectomy. DESIGN A double blinded randomized controlled trial was conducted with 94 patient/parent pairs. METHODS TS and noise recordings were played via headphones post tonsillectomy upon arrival to the Post Anesthesia Care Unit until the child showed signs of waking. FINDINGS Pain scores at 30 minutes post extubation show significantly lower pain in the TS group, P = .04 (Mann Whitney U for independent samples). The TS group had 70% increased likelihood of receiving less intravenous (IV) opioid. CONCLUSION TS may help lower pain in children post tonsillectomy and decrease demand for IV opioid pain management in the 4- to 8-year-old tonsillectomy population.
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Hamilton G, Corlett J, Dowling M. Adult-trained perioperative nurses' practice of family-centered care. ACTA ACUST UNITED AC 2014; 23:477-82. [DOI: 10.12968/bjon.2014.23.9.477] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Grainne Hamilton
- Senior Staff Nurse, Trauma and Orthopaedic Theatres, Sligo Regional Hospital, Ireland
| | - Jo Corlett
- Deputy Dean and Head of Learning and Teaching, School of Nursing and Midwifery, University of Dundee, Scotland
| | - Maura Dowling
- Lecturer at the School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
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Hoetzenecker W, Guenova E, Krug M, Goetz A, Amarov B, Haefner HM, Breuninger H. Parental anxiety and concern for children undergoing dermatological surgery. J DERMATOL TREAT 2013; 25:367-70. [DOI: 10.3109/09546634.2013.814757] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Agostini F, Monti F, Neri E, Dellabartola S, de Pascalis L, Bozicevic L. Parental anxiety and stress before pediatric anesthesia: a pilot study on the effectiveness of preoperative clown intervention. J Health Psychol 2013; 19:587-601. [PMID: 23456215 DOI: 10.1177/1359105313475900] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As induction of pediatric anesthesia can elicit anxiety in children and parents alike, this study was aimed at evaluating the effectiveness of clown intervention in decreasing maternal anxiety and stress in the preoperative phase. Before anesthesia induction, 25 children were randomly assigned to clown intervention and 25 to a control group with a routine procedure. In the waiting room and after separation from the child, maternal anxiety and stress were measured. The results showed that after separation, only in the clown group, maternal state anxiety significantly decreased and the tendency to somatization did not increase. Moreover, after clown intervention, older children's mothers significantly reduced the level of perceived stress. As clown intervention can positively influence maternal anxiety and stress in the preoperative period, its promotion in clinical-hospital environments is recommended.
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Orbach-Zinger S, Ginosar Y, Sverdlik J, Treitel C, MacKersey K, Bardin R, Peleg D, Eidelman LA. Partner's presence during initiation of epidural labor analgesia does not decrease maternal stress: a prospective randomized controlled trial. Anesth Analg 2012; 114:654-60. [PMID: 22253271 DOI: 10.1213/ane.0b013e318241f4f3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Epidural analgesia reduces pain and anxiety during childbirth. In this randomized controlled trial, we sought to determine whether partner presence during the initiation of epidural analgesia reduces stress of both the mother and her partner and their perception of maternal pain. METHODS Healthy, nulliparous women who were accompanied by their partners and requested neuraxial analgesia were enrolled into the study. The study took place in the Labor and Delivery Unit of a large tertiary hospital in Israel. Upon request for epidural analgesia, both partners were assessed for baseline anxiety (numerical rating scale, 0 to 10), systolic blood pressure, heart rate, estimated contraction pain of parturient (verbal rating scale for pain, 0 to 10), and salivary amylase. After measurements, couples were randomized into 1 of 2 groups: "partner in" and "partner out." Immediately after epidural catheter insertion, anxiety, arterial blood pressure, heart rate, and salivary amylase were measured again in both partners. Both partners were asked to complete the State Anxiety Inventory questionnaire measuring current anxiety. The parturient was asked to rate the pain of epidural catheter insertion. The primary outcome measurement was parturient and partner anxiety as assessed by the numerical rating scale. RESULTS Eighty-four couples were randomized (partner in 41, partner out 42, protocol violation 1). At baseline there was no difference in self-reported anxiety of parturients between the partner-in and partner-out groups (median interquartile range 7.5 [6.0 to 9.0] versus 7.0 [3.5 to 8.5]; P = 0.26, difference in medians = -1.0; 95% confidence interval [CI] of difference -2.0 to 1.0). After epidural catheter insertion, parturients in the partner-in group had a higher level of anxiety than those in the partner-out group (8.0 [7.0 to 10.0] versus 7.0 [5.0 to 9.0]; P = 0.03, difference in medians -1.0; 95% CI of difference -2.0 to 0.0). Pain scores during epidural catheter placement were higher in partner-in than in partner-out groups (7.0 [4.0 to 8.0] versus 4.0 [3.0 to 6.0]; P = 0.004, difference in medians = -2.0; 95% CI of difference -3.0 to -1.0). CONCLUSION Partner presence during epidural catheter insertion for labor analgesia did not decrease anxiety levels. To the contrary, anxiety and pain of epidural catheter placement were greater if the partner remained in the room.
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Affiliation(s)
- Sharon Orbach-Zinger
- Department of Anesthesiology, Rabin Medical Center-Beilinson Hospital, 39 Jabotinski St., Petach Tikvah, Israe.
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Arai YCP, Ueda W, Ushida T, Kandatsu N, Ito H, Komatsu T. Increased heart rate variability correlation between mother and child immediately pre-operation. Acta Anaesthesiol Scand 2009; 53:607-10. [PMID: 19419354 DOI: 10.1111/j.1399-6576.2009.01912.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Maternal distress would correlate with the children's mental status, thereby influencing the activity of the autonomic nervous system (ANS) of the children and mothers. We hypothesized that pre-anesthetic maternal ANS activity, when approaching close to their children's operation time, would correlate with children's ANS activity, and that the values of heart rate variability (HRV) would correlate. METHODS We calculated maternal and children's HRVs and analyzed the relationship between the two. A total of 24 pairs of mother and child were analyzed. Maternal and children's HRVs were recorded from the night before the child's surgery to the arrival to the operation room. RESULTS The ratios of low-frequency components (LF) to high-frequency components (HF) (LF/HF ratio) of children's and maternal HRVs obtained during the immediate pre-operative period (06:00-08:00 hours) showed a significantly, positive correlation, but no correlation was found for the LF/HF ratios obtained during the pre-operative night. CONCLUSION The LF/HF ratios of HRV immediately before surgery in children and mothers showed a significant positive correlation.
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Affiliation(s)
- Y-C P Arai
- Multidisciplinary Pain Center, Aichi Medical University, Aichi, Japan.
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An evidence-based review of parental presence during anesthesia induction and parent/child anxiety. Can J Anaesth 2008; 56:57-70. [DOI: 10.1007/s12630-008-9008-3] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 10/14/2008] [Accepted: 10/28/2008] [Indexed: 01/05/2023] Open
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Arai YCP, Sakakibara S, Ito A, Ohshima K, Sakakibara T, Nishi T, Hibino S, Niwa S, Kuniyoshi K. Intra-operative natural sound decreases salivary amylase activity of patients undergoing inguinal hernia repair under epidural anesthesia. Acta Anaesthesiol Scand 2008; 52:987-90. [PMID: 18477078 DOI: 10.1111/j.1399-6576.2008.01649.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The perioperative period is psychologically as well as physically stressful for patients. Although music and sound are known to reduce patients' psychological stress, a few previous studies showed an objective outcome of music. The aim of the present study was to evaluate the relaxing effect of music during epidural anesthesia, using patients' salivary amylase activity. METHODS Thirty-two American Society of Anesthesiologists (ASA) I or II patients presenting for inguinal hernia repair under epidural anesthesia were randomly assigned to listen to sounds of a soft wind and a twitter (S group) or to have no sounds (N group). Patients' salivary amylase activity was evaluated on arrival to the operating room and at wound closure. RESULTS Intra-operative music significantly decreased salivary amylase activity at wound closure in the S group and the activity at wound closure of the S group was significantly smaller than that of the N group. CONCLUSION Intra-operative natural sound significantly decreased salivary amylase activity of patients undergoing inguinal hernia repair under epidural anesthesia.
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Affiliation(s)
- Y-C P Arai
- Multidisciplinary Pain Centre, Aichi Medical University, School of Medicine, Aichi, Japan.
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