JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

ISSN: Active
eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Anxiety of parents and children undergoing gastrointestinal endoscopy correlates with sedative doses
Abstract
Aims: Sedation is a fundamental component of the pediatric gastrointestinal endoscopy (GIE). The dosing of drugs to be used for sedating the child is an important aspect of the efficacy and safety of procedural sedation. Besides, outpatient procedures are stressful situations for pediatric patients and also their families, and therefore, parental anxiety may affect children indirectly. The first aim of the study was to assess the association between parental anxiety and required sedative dose in children undergoing GIE. The second aim was to assess the factors associated with children’s preoperative anxiety. Material and
Methods: This study was a prospective, observational, and single-center study performed by the same fellowship-trained pediatric gastroenterology specialist and the same anesthesiology specialist. Parental anxiety was evaluated with the State-Trait-Anxiety-Scale (STAI) and children's anxiety was evaluated with the Modified Yale Preoperative Anxiety Scale (mYPAS). Midazolam, ketamine, propofol, and fentanyl were administered for the children’s sedation. There were 2 comparisons in this study, the anxiety of parents according to mean STAI scores, and anxiety of children according to mYPAS scores.
Results: Of 120 children and parents, 87 parents (73%) and 57 children (48%) had high anxiety. Of 120 parents, 111 parents (92%) were mothers of the children. Younger children had higher anxiety levels. Before and the start of the GIE heart rates of children were higher both in the high anxiety group of parents and children. In sedatives, high anxiety parents’ children and high anxiety children were required more ketamine dosages. (p<0,05)
Conclusion: Parental anxiety affects anxiety in children having GIE, and this increases the required sedative doses. Children’s younger age, lower weight and high ASA scores were associated with children’s preoperative anxiety.

Keywords : Sedation, pediatrics, parent, endoscopy, preoperative anxiety

Download Article


1. 1. Roelofse J, Jansen van Rensburg M, Gray R, Cherese L. SASApaediatric guidelines for the safe use of procedural sedation andanalgesia for diagnostic and therapeutic procedures in children:2021-2026. South Afr J Anaesth Analg 2021; 27: S1-83.
2. CJ, Wilson S; American academy of pediatrics; americanacademy of pediatric dentistry. Guidelines for monitoring andmanagement of pediatric patients before, during, and aftersedation for diagnostic and therapeutic procedures. Pediatrics2019; 143: e20191000.
3. Cot&eacute; CJ, Karl HW, Notterman DA, Weinberg JA, McCloskey C.Adverse sedation events in pediatrics: analysis of medicationsused for sedation. Pediatrics 2000; 106: 633-44.
4. Aslam SL, Haque A, Jamil MT, Ariff M, Nasir S. Safety and efficacyof procedural sedation and analgesia in pediatric oncologypatients. Cureus 2020; 12: e7442.
5. Cagiran E, Sergin D, Deniz MN, Tanattı B, Emiroglu N, AlperI. Effects of sociodemographic factors and maternal anxiety onpreoperative anxiety in children. J Int Med Res 2014; 42: 572-80.
6. Messeri A, Caprilli S, Busoni P. Anaesthesia induction in children:a psychological evaluation of the efficiency of parents&#39; presence.Paediatr Anaesth 2004; 14: 551.
7. Ayenew NT, Endalew NS, Agegnehu AF, Bizuneh YB. Prevalenceand factors associated with preoperative parental anxiety amongparents of children undergoing anesthesia and surgery: A cross-sectional study. Int J Surg Open 2020; 24: 18-26.
8. Getahun AB, Endalew NS, Mersha AT, Admass BA. Magnitudeand factors associated with preoperative anxiety among pediatricpatients: cross-sectional study. Pediatric Health Med Ther 2020;11: 485-94.
9. Cui X, Zhu B, Zhao J, Huang Y, Luo A, Wei J. Parental stateanxiety correlates with preoperative anxiety in Chinese preschoolchildren. J Paediatr Child Health 2016; 52: 649-55.
10. Hatipoğlu Z, Kırd&ouml;k O, &Ouml;zcengiz D. Validity and reliability of theTurkish version of the modified Yale Preoperative Anxiety Scale.Turk J Med Sci 2019; 49: 730-737.
11. Oner N, Le Compte A. Durumluk-S&uuml;rekli kaygı envanterielkitabı, 20. Basım İstanbul: Boğazi&ccedil;i. &Uuml;niversitesi Yayınları, 1985.s.3-5.
12. Yang SM, Yi DY, Choi GJ, et al. Effects of Sedation Performedby an Anesthesiologist on Pediatric Endoscopy: a Single-CenterRetrospective Study in Korea. J Korean Med Sci 2020; 35: e183.
13. Jurair H, Bhimani A, Anwar-Ul-Haque. Outcome of pediatricprocedural sedation &amp; analgesia in a tertiary care hospital inPakistan. Pak J Med Sci 2015; 31: 1554-7.
14. Kannikeswaran N, Lieh-Lai M, Malian M, Wang B, FarooqiA, Roback MG. Optimal dosing of intravenous ketaminefor procedural sedation in children in the ED-a randomizedcontrolled trial. Am J Emerg Med 2016; 34: 1347-53.
15. Min JY, Lee JR, Kang YS, Ho JH, Byon HJ. Pediatric characteristicsand the dose of propofol for sedation during radiologicalexaminations: a retrospective analysis. J Int Med Res 2021; 49:300060521990992.
16. Vargo J. Sedation and Monitoring in Gastrointestinal Endoscopy,An Issue of Gastrointestinal Endoscopy Clinics of North America,E-Book: Elsevier Health Sciences; 2016.
17. Green SM, Klooster M, Harris T, Lynch EL, Rothrock SG.Ketamine sedation for pediatric gastroenterology procedures. JPediatr Gastroenterol Nutr 2001; 32: 26-33.
18. Kaddu R, Bhattacharya D, Metriyakool K, Thomas R, Tolia V.Propofol compared with general anesthesia for pediatric GIendoscopy: is propofol better? Gastrointest Endosc 2002; 55:27-32.
19. Li XR, Zhang WH, Williams JP, et al. A multicenter surveyof perioperative anxiety in China: Pre- and postoperativeassociations. J Psychosom Res 2021 Aug; 147: 110528.
20. Kallar SK, Jones GW. Postoperative complications. In: White PF,ed. Outpatient anesthesia. New York: Churchill Livingstone, 1990:397- 415.
21. Bumin Aydın G, Sakızcı Uyar B. Mothers Level of Educationand Preoperative Informative Story Book Reading Helps ReducePreoperative Anxiety in Children in Turkey. J Pediatr Nurs 2021;60: e19-e23
22. Dierckx B, Kok R, Tulen JH, Jaddoe VW, Hofman A, Verhulst FC.A prospective study of heart rate and externalising behaviours inyoung children. J Child Psychol Psychiatry 2014; 55: 402-10.
23. MacLaren JE, Thompson C, Weinberg M, et al. Prediction ofpreoperative anxiety in children: who is most accurate? AnesthAnalg 2009; 108: 1777-82.
24. Varughese AM, Nick TG, Gunter J, Wang Y, Kurth CD. Factorspredictive of poor behavioral compliance during inhaledinduction in children. Anesth Analg 2008; 107: 413-21.
25. Chundamala J, Wright JG, Kemp SM. An evidence-based reviewof parental presence during anesthesia induction and parent/childanxiety. Can J Anaesth 2009; 56: 57-70.
26. Facco E, Zanette G, Manani G. Italian version of Corah&#39;s DentalAnxiety Scale: normative data in patients undergoing oral surgeryand relationship with the ASA physical status classification.Anesth Prog 2008; 55: 109-15.
Article available in :
Volume 6, Issue 2, 2023
Page : 238-243
https://doi.org/10.32322/jhsm.1214850
Article Information
Received : 06 Ara 2022
Accepted : 13 Oca 2023
Published : 27 Mar 2023
Corresponding Author :

Elif Erdoğan Öngel: Sancaktepe Şehit Prof. Dr. İlhan Varank Education and Research Hospital, Anesthesiology and Reanimation Department, İstanbul, Turkey

[email protected]
Citation : Erdoğan Öngel E, Tekin S, Polat E, Adıyeke E, Bakan N. Anxiety of parents and children undergoing gastrointestinal endoscopy correlates with sedative doses. J Health Sci Med 2023; 6(2): 238-243.

Read: 159
Cited: 0
Download : 159
_Footer