TY - JOUR
T1 - Real-time assessment of perioperative behaviors and prediction of perioperative outcomes
AU - Sadhasivam, Senthilkumar
AU - Cohen, Lindsey L.
AU - Szabova, Alexandra
AU - Varughese, Anna
AU - Kurth, Charles Dean
AU - Willging, Paul
AU - Wang, Yu
AU - Nick, Todd G.
AU - Gunter, Joel
N1 - Funding Information:
Supported, in part, by the Institute of Pediatric Anesthesia, Cincinnati Children's Hospital Medical Center and by the Foundation for Anesthesia Education and Research's (FAER) mentored training grant. No financial support except departmental salary support for the authors. This work received the Young investigator award from the Society of Pediatric Anesthesia in 2007.
PY - 2009/3
Y1 - 2009/3
N2 - BACKGROUND AND AIMS: New onset maladaptive behaviors, such as temper tantrums, nightmares, bed-wetting, attention-seeking, and fear of being alone are common in children after outpatient surgery. Preoperative anxiety, fear and distress behaviors of children predict postoperative maladaptive behaviors as well as emergence delirium. Parental anxiety has also been found to influence children's preoperative anxiety. Currently, there is no real-time and feasible tool to effectively measure perioperative behaviors of children and parents. We developed a simple and real-time scale, the Perioperative Adult Child Behavioral Interaction Scale (PACBIS) to assess perioperative child and parent behaviors that might predict postoperative problematic behavior and emergence excitement. METHODS: We used the PACBIS to evaluate perioperative behaviors during anesthetic induction and recovery in a sample of 89 children undergoing tonsillectomies and adenoidectomies, and their parents. Preoperative anxiety with the modified Yale Preoperative Anxiety Scale, compliance with induction of anesthesia with Induction Compliance Checklist, and incidence of emergence excitement were also recorded. RESULTS: The PACBIS demonstrated good concurrent validity with modified Yale Preoperative Anxiety Scale and Induction Compliance Checklist and predicted postanesthetic emergence excitement. DISCUSSION: The PACBIS is the first real-time scoring instrument that evaluates children's and parents' perioperative behavior. The specific behaviors identified by the PACBIS might provide targets for interventions to improve perioperative experiences and postoperative outcomes.
AB - BACKGROUND AND AIMS: New onset maladaptive behaviors, such as temper tantrums, nightmares, bed-wetting, attention-seeking, and fear of being alone are common in children after outpatient surgery. Preoperative anxiety, fear and distress behaviors of children predict postoperative maladaptive behaviors as well as emergence delirium. Parental anxiety has also been found to influence children's preoperative anxiety. Currently, there is no real-time and feasible tool to effectively measure perioperative behaviors of children and parents. We developed a simple and real-time scale, the Perioperative Adult Child Behavioral Interaction Scale (PACBIS) to assess perioperative child and parent behaviors that might predict postoperative problematic behavior and emergence excitement. METHODS: We used the PACBIS to evaluate perioperative behaviors during anesthetic induction and recovery in a sample of 89 children undergoing tonsillectomies and adenoidectomies, and their parents. Preoperative anxiety with the modified Yale Preoperative Anxiety Scale, compliance with induction of anesthesia with Induction Compliance Checklist, and incidence of emergence excitement were also recorded. RESULTS: The PACBIS demonstrated good concurrent validity with modified Yale Preoperative Anxiety Scale and Induction Compliance Checklist and predicted postanesthetic emergence excitement. DISCUSSION: The PACBIS is the first real-time scoring instrument that evaluates children's and parents' perioperative behavior. The specific behaviors identified by the PACBIS might provide targets for interventions to improve perioperative experiences and postoperative outcomes.
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U2 - 10.1213/ane.0b013e318195c115
DO - 10.1213/ane.0b013e318195c115
M3 - Article
C2 - 19224789
AN - SCOPUS:61949099803
SN - 0003-2999
VL - 108
SP - 822
EP - 826
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 3
ER -