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Perioperative anxiety and postoperative behavioural disturbances in children: comparison between induction techniques

Published online by Cambridge University Press:  01 March 2006

N. Bal ,
F. Saricaoglu ,
S. Uzun ,
D. Dal ,
N Çelebi ,
V. Çeliker  and
Ü Aypar
N. Bal
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
F. Saricaoglu
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
S. Uzun
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
D. Dal
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
N Çelebi
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
V. Çeliker
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
Ü Aypar
Affiliation:
Hacettepe University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
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Extract

Summary

Background and objective: This study was designed to determine if subhypnotic propofol reduces postoperative behavioural disturbances in children undergoing sevoflurane induction compared with intravenous propofol induction for elective adenoidectomy and tonsillectomy. Methods: Following Ethics Committee approval and parental informed consent, ASA I–II, 120 children (2–10 yr) were recruited. Parents were not allowed to accompany their child. Unpremedicated children were randomly allocated to groups receiving inhalation induction with sevoflurane, 2–2.5 mg kg−1 intravenous propofol induction or inhalation induction with sevoflurane followed by subhypnotic dose of propofol (1 mg kg−1). Anaesthesia was maintained with 2–4% sevoflurane, O2 and N2O. Anxiety on arrival to operating theatre, at anaesthesia induction and 30 min after emergence was assessed. Parents completed a state–trait anxiety inventory test preoperatively and a post hospitalization behaviour questionnaire a week later to assess children's postoperative behavioural disturbances. Kruskal–Wallis test, Wilcoxon signed rank sum test, Bonferroni's test, Paired t-test, t-test, Pearson and Spearman's rank correlation test, χ2-test were used for statistical analysis. Results: The anxiety level at induction was high in all groups (P < 0.05). There was no difference between groups in respect to anxiety at other measurement times. A relation between preoperative anxiety level and postoperative behavioural disturbances was determined (P < 0.05). Some behavioural disturbances as nightmare/night fear and desire of sleeping with parents were rarely seen in intravenous propofol induction group (P < 0.05). Conclusion: Addition of subhypnotic dose of propofol to sevoflurane induction did not reduce the incidence of postoperative behavioural disturbances.

Keywords

ANAESTHETICS, INTRAVENOUS, propofolANAESTHETICS, VOLATILE, sevofluranePERIOPERATIVE ANXIETYPOSTOPERATIVE BEHAVIOURAL DISTURBANCE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 6 , June 2006 , pp. 470 - 475
Copyright
© 2006 European Society of Anaesthesiology

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