ABSTRACT
BACKGROUND AND AIMS: There have been various methods tested for reducing preoperative anxiety in children, but very limited literature is available in the Indian scenario. Our aim was to analyse the effect of an informative video about the anaesthetic technique on preoperative anxiety in children. METHODS: In all, 94 children were randomly allotted into two groups. Children in the study group were shown a peer modelling video depicting induction of general anaesthesia and recovery during the preanaesthetic check (PAC). Patients in the control group were given only verbal information during PAC. Anxiety was assessed on visual analog scale (VAS) for anxiety at two times. Baseline VAS score was recorded during PAC and preoperative VAS score was assessed prior to induction of anaesthesia. The VAS score was represented as median value. Data were analysed using the Mann-Whitney U-test for ordinal data and skewed quantitative data. Categorical data was analysed by using Chi-square test and t-test was applied for quantitative data. The significance threshold of P value was set at <0.05. RESULTS: The median (interquartile range) preoperative VAS score was significantly lower in the study group [1 (0-1.3)] when compared with the control group [5 (3-5)] (P < 0.001). The mean preoperative pulse rate, mean preoperative systolic blood pressure and mean preoperative diastolic blood pressure were significantly lower in the study group when compared with the control group (P < 0.001). CONCLUSION: Multimedia information in the form of a peer modelling video helped reduce preoperative anxiety in children between 7 and 12 years of age.
ABSTRACT
BACKGROUND AND AIMS: Measurement of end-tidal anaesthetic gas concentrations (ETAG) is currently a pragmatic indicator for monitoring anaesthetic depth. We aimed to assess the performance of ETAG for sevoflurane (ETAG-sevo) with bispectral index (BIS) and difference between inspired and end-tidal oxygen concentration (Fi-Et)O2% in measuring anaesthetic depth in toddlers and preschool children. Primary outcome was to correlate BIS with ETAG-sevo. Secondary outcome was to correlate (Fi-Et)O2% with ETAG-sevo and to derive cut-off value of (Fi-Et)O2%which corresponds with light planes of anaesthesia [minimum alveolar concentration (MAC <0.6)]. METHODS: Thirty patients between 1 and 5 years of age undergoing short procedures were included. ETAG, MAC, BIS and (Fi-Et)O2% were measured at intubation, maintenance phase, last 15 min of surgery, end of surgery, extubation, recovery. Pearson's correlation coefficient was used to measure correlation. Receiver operating characteristic (ROC) curves were used to derive cut-off value of (Fi-Et)O2% which corresponded with MAC <0.6. RESULTS: BIS correlated poorly with ETAG at all time intervals. Significant correlation was seen between (Fi-Et)O2% and ETAG at intubation (P = 0.042), last 15 min of surgery (P = 0.019) and end of surgery (P = 0.001). Cut-off value >7 was obtained for (Fi-Et)O2% corresponding to MAC <0.6 at extubation with area under ROC curve0.955 (95% confidence interval 0.811-0.997), with sensitivity 0.8571 and specificity 1.00. CONCLUSION: BIS was an unreliable measure of anaesthetic depth. (Fi-Et)O2% values >7 corresponded with light planes of anaesthesia.
