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Premedication in children: hypnosis versus midazolam.
Séverine Calipel1, Marie-Madeleine Lucas-Polomeni, Eric Wodey
1Department of Anesthesiology and Surgical Intensive Care 2, Hôpital Pontchaillou, Université de Rennes 1, Rennes, France.
Paediatric Anaesthesia
|March 25, 2005
Summary
Hypnosis effectively reduces preoperative anxiety and postoperative behavioral disorders in children undergoing surgery, offering a promising alternative to midazolam premedication. This technique alleviates anxiety during anesthesia induction and decreases behavioral issues in the first week post-surgery.
Area of Science:
- Pediatric Anesthesiology
- Behavioral Psychology
- Complementary Medicine
Background:
- Premedication in children aims to reduce anxiety, ease separation from parents, and prevent postoperative behavioral issues.
- Midazolam is the standard sedative premedication, but hypnosis has not been evaluated for this purpose.
- This study compares the efficacy of hypnosis versus midazolam for pediatric surgical premedication.
Purpose of the Study:
- To evaluate the efficacy of hypnosis as a premedication technique in children.
- To compare hypnosis with midazolam in reducing preoperative anxiety.
- To assess the impact of hypnosis on postoperative behavioral disorders.
Main Methods:
- Fifty children aged 2-11 years were randomized into hypnosis (Group H) or midazolam (Group M) groups.
- Preoperative anxiety was measured using the Modified Yale Preoperative Anxiety Scale (mYPAS) at three time points.
- Postoperative behavioral disorders were assessed using the Posthospitalization Behavioral Questionnaire (PHBQ) on days 1, 7, and 14.
Main Results:
- No significant preoperative differences in PHBQ or mYPAS scores were observed between groups.
- Hypnosis group showed significantly lower anxiety during anesthesia induction (T3: 39% vs 68%, P < 0.05).
- Postoperatively, hypnosis reduced behavioral disorders by approximately half on days 1 (30% vs 62%) and 7 (26% vs 59%).
Conclusions:
- Hypnosis is an effective premedication strategy for pediatric surgical patients.
- It successfully alleviates preoperative anxiety, particularly during anesthesia induction.
- Hypnosis significantly reduces the incidence of postoperative behavioral disorders within the first week.