Related Experiment Videos
The perioperative dialogue reduces postoperative stress in children undergoing day surgery as confirmed by salivary
Berith Wennström1, Carl-Johan Törnhage, Salmir Nasic
1Department of Anaesthesia, Skaraborg Hospital, Skövde, Sweden. berith.wennstroem@telia.com
Insights
The perioperative dialogue (PD) intervention significantly reduced salivary cortisol levels and morphine use in children undergoing day surgery. This approach enhances patient care and recovery by addressing pre-operative anxiety and improving outcomes.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Psychoneuroendocrinology
Background:
- Children require confidence and information to manage pre-operative anxiety.
- Intervention strategies for pediatric surgical patients should commence before hospital admission.
Purpose of the Study:
- To assess the effectiveness of the perioperative dialogue (PD) in managing stress response.
- To analyze salivary cortisol levels in children aged 5-11 undergoing day surgery.
Main Methods:
- Randomized controlled trial involving 93 children undergoing elective day surgery.
- Three groups: standard care, standard care with pre-operative information, and PD.
- Salivary cortisol levels measured at key pre- and peri-operative time points.
Main Results:
- The PD group exhibited significantly lower post-operative salivary cortisol levels (P=0.003).
- Children in the PD group required less morphine for pain management (P=0.014).
- A positive correlation was observed between morphine consumption and salivary cortisol levels (r=0.56, P=0.038).
Conclusions:
- The perioperative dialogue (PD) is a valuable addition to standard care for pediatric day surgery.
- PD is associated with reduced physiological stress (salivary cortisol) and analgesic requirements.
- The intervention's focus on continuity and dialogue supports improved patient outcomes.
Aim:
To evaluate the efficacy of 'the perioperative dialogue (PD)' by analyzing salivary cortisol, in 5- to 11-year-old children undergoing day surgery.
Background:
To deal with anxiety prior to investigations and/or procedures, children need to be confident and informed about what is going to happen. Therefore, intervention strategies should be initiated before admission to hospital.
Methods And Materials:
Children (n = 93), 79 boys and 14 girls, scheduled for elective day surgery requiring general anesthesia were randomly recruited into three groups: (i) standard perioperative care (n = 31), (ii) standard perioperative care including preoperative information (n = 31), and (iii) the PD (n = 31). Saliva was sampled for cortisol analysis at specific time points during the pre- and perioperative procedures.
Results:
The children who received the PD had significantly lower (P = 0.003) salivary cortisol concentrations postoperatively. Moreover, it continuously decreased during the day of surgery compared with the other two groups (P < 0.01). Among the children who received analgesics, the PD group received significantly less morphine (P = 0.014) related to bodyweight: the mean dose was 0.1 mg·kg(-1) (n = 9) in the control group vs 0.04 mg·kg(-1) (n = 6) in the PD group. Irrespective of group, there was a positive correlation between the children's morphine consumption and salivary cortisol concentration (r = 0.56; P = 0.038). The W-B scale score was higher in the group that received morphine (median = 3 vs median=1; P = 0.001).
Conclusions:
The PD's caring, continuity, and on-going dialogues were associated with low concentrations of salivary cortisol postoperatively and reduced morphine consumption and thus appears to be a valuable complement to standard perioperative care in children undergoing day surgery.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management