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Allaying Pediatric Preoperative Anxiety, Where are we Now? - A Nationwide Survey
Shreya Bharat Shah1, Renu Sinha1, Sana Yasmin Hussain1
1Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Insights
Preoperative anxiety (PA) management in children is inconsistent among anesthesiologists, with only 37% using strategies consistently. Improved awareness and a multidisciplinary approach are needed to establish it as standard pediatric anesthesia care.
Area of Science:
- Pediatric Anesthesiology
- Patient Outcomes
- Perioperative Care
Background:
- Preoperative anxiety (PA) in children is common and linked to adverse outcomes.
- Managing PA is a standard of care but often neglected.
- Current practices and anesthesiologists' attitudes towards PA management in children require evaluation.
Purpose of the Study:
- To assess nationwide practice patterns of anesthesiologists regarding pediatric preoperative anxiety.
- To understand anesthesiologists' attitudes towards allaying preoperative anxiety in children.
- To identify barriers and facilitators in implementing anxiety-relieving strategies.
Main Methods:
- A 25-question survey was distributed to anesthesiologists nationwide.
- The survey covered methods, noncompliance reasons, and complications of PA relief.
- Data was collected via online (Google Forms) and manual distribution.
Main Results:
- 97% of 450 surveyed anesthesiologists used anxiety-relieving strategies, but only 37% consistently.
- Pharmacological and nonpharmacological techniques were used by 73%.
- Key barriers included anticipated difficult airway (88%) and inadequate hospital infrastructure (67%).
Conclusions:
- Pediatric preoperative anxiety management is inconsistently applied, with significant practice variations.
- A collaborative approach involving anesthesiologists, surgeons, and nurses is essential.
- Enhanced awareness and improved infrastructure are crucial to standardize PA-relieving services.
Background:
Preoperative anxiety (PA) in children is a common phenomenon associated with various negative patient outcomes. Allaying PA is accepted as a standard of care, but its use is not universal and often overlooked. This survey is designed to evaluate the nationwide current practice patterns and attitudes of anesthesiologists toward the practice of allaying PA in children.
Materials And Methods:
A questionnaire of 25 questions, including information on methods of relieving PA in children, reasons for noncompliance, and associated complications, was framed. It was circulated among members of the Indian Society of Anaesthesiologists through an online survey of Google Forms and manually.
Results:
Four hundred and fifty anesthesiologists were surveyed. Responses were predominantly from anesthesiologists practicing in medical colleges across the country. Although 97% of the surveyed respondents practiced anxiety-relieving strategies, only 37% used it consistently. Seventy-three percent of anesthesiologists practiced both pharmacological and nonpharmacological techniques. The most common reason for avoiding premedication was an anticipated difficult airway (88%). Inadequate sedation was a commonly reported problem. Ninety-five percent of participants felt that PA-relieving strategies should be integral to pediatric anesthesia practice. The most common reason for not following these practices was an inadequate hospital infrastructure (67%). Ninety-seven percent of the participants believed that more awareness is required on this crucial perioperative issue.
Conclusion:
Only 37% of the surveyed anesthesiologists consistently used some form of PA-relieving strategy and the practice varied widely. Further improvement and team approach involving anesthesiologists, surgeons, and nurses is required to ensure the quality of pediatric PA-relieving services and establish it as a standard of care.
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