Factors associated with a difficult induction of general anaesthesia
Source: Cochlear Implants International, Volume 12, Supplement 2, August 2011 , pp. S30-S32(3)
Publisher: Maney Publishing
Many children experiencing a procedure under general anaesthetic (GA), including those having surgery for cochlear implantation, display behaviours indicative of distress during induction of anaesthesia. It would be useful to ascertain which factors in the pre-operative period are related to the presence of distress at induction in order to target appropriate psychological preparation.
The families of 84 children aged 4‐7 years undergoing a procedure under GA (including insertion of a cochlear implant) completed three questionnaires assessing temperament, behavioural difficulties, and pre-operative worries. Demographic variables were also recorded. The outcome measure was the amount of behavioural distress at induction.
Statistically significant relationships with the outcome measure of distress at induction were obtained for three factors; an emotional or sociable temperament, and the number of previous procedures. Further, children receiving inhalation inductions displayed greater distress than those receiving intravenous inductions.
Undergoing cochlear implantation under GA is a major life event for many recipients. Psychologically preparing children for this has been found to be efficacious, but is not currently available to all children. It is suggested that preparation can be targeted at children, as identified in this study, who have elevated emotionality or sociability scores or who have previous experience of procedures under general anaesthesia. This is of particular current relevance as children are increasingly likely to require re-implantation as they grow older and as unilaterally implanted children are now being offered a sequential bilateral implant, both necessitating further surgery.
Document Type: Research Article
Affiliations: 1: Paediatric Auditory Implant Service, Guy's and St Thomas' Foundation NHS, London, UK 2: Great Ormond Street Hospital for Children, London, UK 3: 2gether Foundation Trust for Herefordshire, CAMHS, Hereford, UK 4: University of Surrey, Guildford, UK
Publication date: August 2011