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Child related background factors affecting compliance with induction of anaesthesia

Proczkowska-Bjorklund, Marie and Svedin, Carl Göran LU (2004) In Paediatric Anaesthesia 14(3). p.225-234
Abstract
BACKGROUND: Factors such as age, sex, behaviour problems, fears, earlier traumatic hospital events and reactions to vaccination were assessed together with behaviour observed before premedication in order to evaluate their importance in predicting response to the anaesthetic process. The anaesthetic process was divided into four endpoints; compliance when given premedication, sedation, compliance during needle insertion or when an anaesthetic mask was put in place and behaviour when put to sleep. METHODS: A total of 102 children who were undergoing day-stay surgery and overnight stay surgery were video-filmed during premedication and anaesthetic induction. Before premedication the children and parents answered questionnaires about... (More)
BACKGROUND: Factors such as age, sex, behaviour problems, fears, earlier traumatic hospital events and reactions to vaccination were assessed together with behaviour observed before premedication in order to evaluate their importance in predicting response to the anaesthetic process. The anaesthetic process was divided into four endpoints; compliance when given premedication, sedation, compliance during needle insertion or when an anaesthetic mask was put in place and behaviour when put to sleep. METHODS: A total of 102 children who were undergoing day-stay surgery and overnight stay surgery were video-filmed during premedication and anaesthetic induction. Before premedication the children and parents answered questionnaires about behaviour [Preschool Behaviour Check List (PBCL)] and fears [Fears Survey Schedule for Children-Revised (FSSC-R)]. The films were analysed to assess behaviour before and after premedication and during induction of anaesthesia. A semistructured interview was conducted with the parents during the time the children were asleep. RESULTS: There was a significantly higher odds ratio for noncompliant behaviour during premedication if the child placed itself in the parent's lap or near the parent or had previously experienced traumatic hospital events. The odds ratio for not being sedated by premedication was higher if compliance was low when premedication was given or the child had experienced a traumatic hospital event in the past. A high odds ratio for noncompliant behaviour during venous access or placement of an anaesthetic mask was seen if the child was not sedated or the child had had a negative reaction when vaccinated. The odds ratio for falling asleep in an anxious or upset state was higher if the child had shown noncompliant behaviour during premedication, had not been sedated or had shown noncompliant behaviour during venous access or facemask placement. CONCLUSIONS: The overall most important factor that predicts noncompliant behaviour and a distressed state in the child during the anaesthetic process was the experience of earlier traumatic hospital events including negative reaction to vaccination. All elements of the process are important in determining what will happen and all steps will influence how the child reacts when put to sleep. (Less)
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author
publishing date
type
Contribution to journal
publication status
published
subject
in
Paediatric Anaesthesia
volume
14
issue
3
pages
225 - 234
publisher
Wiley-Blackwell
external identifiers
  • pmid:14996261
  • scopus:1642380470
ISSN
1460-9592
DOI
10.1046/j.1460-9592.2003.01185.x
language
English
LU publication?
no
id
2150e98c-e000-4954-9a2e-f0251c58a7fc (old id 1131128)
date added to LUP
2008-06-18 10:40:05
date last changed
2017-01-01 07:23:33
@article{2150e98c-e000-4954-9a2e-f0251c58a7fc,
  abstract     = {BACKGROUND: Factors such as age, sex, behaviour problems, fears, earlier traumatic hospital events and reactions to vaccination were assessed together with behaviour observed before premedication in order to evaluate their importance in predicting response to the anaesthetic process. The anaesthetic process was divided into four endpoints; compliance when given premedication, sedation, compliance during needle insertion or when an anaesthetic mask was put in place and behaviour when put to sleep. METHODS: A total of 102 children who were undergoing day-stay surgery and overnight stay surgery were video-filmed during premedication and anaesthetic induction. Before premedication the children and parents answered questionnaires about behaviour [Preschool Behaviour Check List (PBCL)] and fears [Fears Survey Schedule for Children-Revised (FSSC-R)]. The films were analysed to assess behaviour before and after premedication and during induction of anaesthesia. A semistructured interview was conducted with the parents during the time the children were asleep. RESULTS: There was a significantly higher odds ratio for noncompliant behaviour during premedication if the child placed itself in the parent's lap or near the parent or had previously experienced traumatic hospital events. The odds ratio for not being sedated by premedication was higher if compliance was low when premedication was given or the child had experienced a traumatic hospital event in the past. A high odds ratio for noncompliant behaviour during venous access or placement of an anaesthetic mask was seen if the child was not sedated or the child had had a negative reaction when vaccinated. The odds ratio for falling asleep in an anxious or upset state was higher if the child had shown noncompliant behaviour during premedication, had not been sedated or had shown noncompliant behaviour during venous access or facemask placement. CONCLUSIONS: The overall most important factor that predicts noncompliant behaviour and a distressed state in the child during the anaesthetic process was the experience of earlier traumatic hospital events including negative reaction to vaccination. All elements of the process are important in determining what will happen and all steps will influence how the child reacts when put to sleep.},
  author       = {Proczkowska-Bjorklund, Marie and Svedin, Carl Göran},
  issn         = {1460-9592},
  language     = {eng},
  number       = {3},
  pages        = {225--234},
  publisher    = {Wiley-Blackwell},
  series       = {Paediatric Anaesthesia},
  title        = {Child related background factors affecting compliance with induction of anaesthesia},
  url          = {http://dx.doi.org/10.1046/j.1460-9592.2003.01185.x},
  volume       = {14},
  year         = {2004},
}