Improving the Quality of Anesthesia Induction by Reducing Preoperative Anxiety in the Operating Room

Assistance Publique Hopitaux De Marseille60 enrolled

Overview

Preoperative anxiety refers to a range of physical and/or psychological manifestations, which can have a significant impact on medical outcomes and the experience of the child and their parents. This study aims to evaluate the impact of preoperative preparation combined with a hypnosis session conducted by nurse anesthetists (IADE) trained in working with children and their families. The goal is to improve the child's experience and reduce perioperative anxiety and stress. It is divided into two phases: * First phase, called "Before": Standard preoperative care is provided according to the existing protocol in the department. Anxiety levels will be measured at the time of induction in the operating room. * Second phase, called "After": In the two weeks prior to surgery, in addition to the standard preoperative care currently in place, the patient will receive a 30-minute visit from a nurse anesthetist trained in hypnosis. This is an added procedure complementing the anesthesia consultation. The visit is divided into two parts: 10 minutes to review and clarify the explanations given by the anesthesiologist and surgeon, and 20 minutes of a formal hypnosis session. A personalized liaison form will be completed to facilitate communication between the consultation and the operating room. Anxiety levels will again be measured at the time of induction.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

Conditions

Anxiety at Induction of Pediatric Anesthesia

Eligibility

Sex: ALLMin age: 5 YearsMax age: 12 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Children aged between 5 and 12 years, i.e., able to engage in verbal communication; * Scheduled for surgery requiring hospitalization at least one day prior to the procedure, including but not limited to gastrointestinal or urological surgery, ENT procedures, plastic interventions, and orthopedic surgery (e.g., scoliosis correction); * Provision of written informed consent by the parents or legal guardians (or by the sole parent/legal guardian, where applicable); * Parental agreement to participate in the study by completing the required questionnaires;Affiliation with or entitlement to a national social security scheme Exclusion Criteria: * Patients with cognitive developmental disorders; * Patients requiring regular general anesthesia as part of ongoing medical management; * Patients undergoing emergency surgery; * Patients with a known psychiatric disorder; * Patients diagnosed with an autism spectrum disorder (ASD).

Outcomes

Primary Outcomes

Children's perioperative anxiety levels at the time of anesthetic induction as assessed by the mYPAS

Mesure of the Modified Yale Preoperative Anxiety Scale by anesthetics or surgical nurse. The total score ranges from 23 to 100: children are considered moderately anxious for a score above 24, and highly anxious for a score above 30.

Time frame: Day 1 ( Anesthesia induction and surgery)

Secondary Outcomes

Children's compliance during induction as assessed by the Induction Compliance Checklist

Induction compliance check list at the time of anesthetic induction

Time frame: Day 1 (Anesthesia induction)

Time spent in the PACU

Duration in minutes between arrival in the PACU and return to the hospital room

Time frame: Day 1 ( From arrival in the PACU until return to the hospital room)

Postoperative delirium as assessed by the PAED Scale

Assessed in the PACU using the PAED scale (Pediatric Anesthesia Emergence Delirium).

Time frame: Day 1 (After surgery)

Postoperative pain as assessed by the VAS scale

Evaluated in the recovery room using the Visual Analogue Scale (VAS). Total scole ranging from 0 to 10 where a higher scores mean worse pain.

Time frame: Day 1 (After surgery)

Postoperative pain as assessed by the FLACC scale.

Evaluated in the recovery room using the Face Legs Activity Cry Consolability (FLACC) scale. Total scole ranging from 0 to 10 where a higher scores mean worse pain.

Time frame: Day 1 (After surgery)

Postoperative pain as assessed by the PPMP scale

Assessed by parents on postoperative days 2 and 5 using the Parents' Postoperative Pain Measure (PPPM), either during hospitalization or via telephone follow-up. The score ranges from 0 to 15, where a higher scire mean worse pain

Time frame: Day 2 and 5 after sugery

Behavioral assessment

The child's postoperative behavior will be assessed on postoperative days 2, 5, and 14 using the PHBQ (Post-Hospitalization Behavior Questionnaire), either in the hospital or via a phone call.

Time frame: Day 1, 2 and 5 after sugery

Parental satisfaction

Assessed via a dedicated questionnaire, either in the hospital or through a phone call

Time frame: At the day of patiet sicharge or Day 14 postoperatevly

Improving the Quality of Anesthesia Induction by Reducing Preoperative Anxiety in the Operating Room

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts