The key to better child behavior after surgery may be a more peaceful operating room.
“The period before, during and after surgery is a particularly unpredictable time for parents,” explained Nguyen Tram, a research scientist at Nationwide Children's Hospital in Columbus, Ohio.
"By implementing some small measures in the OR, we found we were able to markedly improve some of this uncertainty for parents in the key behavioral areas of mood, eating and engagement,” added Tram, lead author of a new study.
Excessive noise in the operating room can increase anxiety and negatively affect patient safety and comfort. This is especially true when anesthesia is administered and when the patient emerges from anesthesia, the research team said in background notes.
For the study, the researchers looked at post-operative behavior in children by creating two different types of operating room conditions for 64 preschool-age kids. They were having anesthesia for tonsillectomy/adenoidectomy or a dental procedure.
The "control group" experienced standard operating room noise levels. The other group were in a “reduced noise” setting with muted communication devices, reduced OR personnel and ambient lighting.
All got a standard oral sedative prior to the anesthesia.
The researchers used a checklist that measures adverse behavior before delivery of anesthesia and assessed patients' anxiety using a pre-operative anxiety scale. To review post-op behavior, they had parents complete a questionnaire on days one and five after surgery.
Children in the reduced noise group had fewer tantrums, according to parent responses. They were also less fussy about eating, as well as more interested in what was going on around them.
This behavior after having a quiet environment after general anesthesia may be similar to how most people need a quiet environment for a good night's sleep, the researchers suggested.
“We've been able to show how reduced noise in the OR can improve post-operative behavior in children in the first several days after having general anesthesia,” Tram said.
“Excessive noise not only directly affects patients but can potentially impact patient safety by impairing provider communication and recognition of audible and visual alarms during the critical induction period," he added.
The findings were presented Monday at the American Society of Anesthesiologists' annual meeting, in New Orleans. Research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
The American Academy of Pediatrics has more on pediatric surgery.
SOURCE: American Society of Anesthesiologists, news release, Oct. 24, 2022