The effectiveness of a multimodal preoperative anxiety intervention on postanesthetic emergence delirium in preschoolers
Keywords:
Emergence delirium, multimodal intervention, postanesthetic, preoperative anxiety, preschoolersAbstract
Background: Preoperative anxiety has been reported as one of the major contributors to emergence delirium (ED) in preschoolers.
Objective: This study investigated the effectiveness of multimodal preoperative anxiety intervention (MPreop-AI) in reducing the incidence and severity of ED in preschoolers.
Methods: A prospective study, posttest only nonequivalent groups design, was conducted in 44 children aged 2 - 6 years scheduled for tonsillectomy and/or adenoidectomy under sevoflurane anesthesia. They were equally allocated into two groups. The usual preoperative preparation group (control group) received narrative preoperative education, parental presence, and self-selected toy. The MPreop-AI group received 2-Dimensional (2D) animation modeling-based information, an operating room tour and the self-selected 2D distraction cartoon. Data were collected using the Pediatric Anesthesia Emergence Delirium Scale (PAED scale) for measuring ED.
Results: There was a significant difference in the incidence of ED between the MPreop-AI group and the control group (9.1% vs. 54.5%, P = 0.004). The percentage of children experiencing severe ED was significantly lower in the MPreop-AI group than in the control group (4.5% vs. 45.5%, P = 0.005).
Conclusions: The study proposes an innovative intervention for psychological preparation in preschooler prior to surgery in order to reduce emergence delirium. The approach is convenient and attractive to preschoolers and may be used to enhance the quality of care.
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