Pharmacological and non-pharmacological interventions to alleviate anxiety before pediatric anesthesia: a survey of current practice in Korea

Abstract

Background: This study was undertaken to determine current practice for preoperative anxiety reduction in Korean children. Methods: An email survey of all members (n = 158) of the Korean Society of Pediatric Anesthesiologists was conducted from November 2014 to January 2015 to assess current practice, preferences, and general opinions regarding pharmacological and non-pharmacological interventions performed to alleviate preoperative anxiety in children prior to general anesthesia.Results: Forty-one anesthesiologists completed the survey; a response rate of 26%. Only 4.9% of respondents undertook anxiety reduction according to a written hospital policy, and 95.1% did not. Most respondents (70.7%) performed anxiolytic intervention guided by informally standardized hospital protocol. In clinical practice, 90% of respondents used pharmacological and/or non-pharma- cological intervention to alleviate anxiety in children. Nearly half of the respondents (53.7%) used premedication to reduce anxiety, and midazolam was most frequently used. Parental presence during induction of anesthesia was considered the most effective non-pharmacological intervention (60.4%), and was allowed by 78% of respondents, and watching a video was considered the second most effective intervention (27.1%).Conclusions: Korean pediatric anesthesiologists use both phar- macological and non-pharmacological interventions to alleviate preoperative anxiety, and these interventions are generally guided by an informally standardized hospital protocol. Anesthesiologists requiring effective anxiety reduction prefer pharmacological interven- tion and most commonly use intravenous midazolam, whereas those that want safe anxiety reduction prefer non-pharmacological Received: June 24, 2015. Revised: September 3, 2015. Accepted: September 21, 2015.Corresponding author: Sung Mee Jung, M.D., Department of Anesthesiology and Pain Medicine, Yeungnam University School of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu 42415, Korea. Tel: 82-53-620-3368, Fax: 82-53-626-5275, E-mail: applejsm@gmail.com This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.55 intervention and most frequently use parental presence during induction of anesthesia