Efficacy of combination of multiple measures in preventing agitation during recovery from general anesthesia in preschool children

Abstract

Objective To evaluate the efficacy of combination of multiple measures in preventing agitation during recovery from general anesthesia in the preschool children. Methods Four hundred and fifty preschool pediatric patients of both sexes, aged 3-6 yr, weighing 16-25 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective monocular strabismus surgery, were divided into 3 groups (n=150 each) using a random number table method: routine prevention group (groupⅠ), midazolam-routine prevention group (groupⅡ) and cartoon video-assisted admission to operating room-family members accompanying in postanesthesia care unit (PACU)-routine prevention group (group Ⅲ). Dexmedetomidine 0.3 μg/kg was intravenously infused over 10 min in groupⅠ.On the basis of groupⅠ, midazolam 0.05 mg/kg was intravenously infused in the holding area in group Ⅱ, and children were admitted to the operating room while they were watching cartoons selected by themselves when accompanied by family members, and they were also accompanied by family members in PACU in group Ⅲ.The modified Yale Preoperative Anxiety Scale score on admission to the operating room, Induction Compliance Checklist score, occurrence and degree of agitation during the recovery period, emergence time and duration of PACU stay were recorded. Results Compared with groupⅠ, the modified Yale Preoperative Anxiety Scale score on admission to the operating room and Induction Compliance Checklist score were significantly decreased, and the incidence of agitation during the recovery period (25.3% in group Ⅰ, 12.0% in group Ⅱ, 3.3% in group Ⅲ) was decreased in Ⅱ and Ⅲ groups , and the emergence time and duration of PACU stay were significantly prolonged in groupⅡ (P 0.05). Conclusion Cartoon video-assisted admission to operating room-family members accompanying in PACU-routine prevention can effectively prevent the occurrence of agitation during recovery from general anesthesia in the preschool children. Key words: Child, preschool; Anesthesia, general; Anesthesia recovery period; Agitation