ABSTRACT
The goal of this study was to evaluate the preoperative anxiety in children and adolescents and to identify some of the risk factors associated with the incidence of anxiety in 9-18 years old group. Children and adolescents 9-18 years old hospitalized the night before elective surgeries were analyzed in terms of incidence and severity of anxiety using the State-Trait Anxiety Inventory (STAI) measure. Of the 164 patients, 111 (67.6%) suffered from preoperative anxiety. The incidence of anxiety in children aged 9-12 was 2.88 times the anxiety of those aged 12-18 (OR = 2.88) (1.65, 5.98). Moreover, the incidence of anxiety in only children was 0.65 times that of children with siblings (OR = 0.78) (0.11,2.93) , and in patients with a history of hospitalization, the incidence was 1.85 times the stress in children without hospitalization history (OR = 1.85)(1.31,3.99); finally, the incidence of anxiety in children of higher socioeconomic status was lower compared with those of lower socioeconomic status (OR = 0.13) (0.08,0.35). Having close frend or family in the healthcare staff decreased the prevalence (OR = 0.64 (0.23,1.79) and severity of anxiety (47.02 ± 5.48 vs. 54.18 ± 7.18) (P-value = 0.001). There was no relationship between gender and the incidence of anxiety (OR = 1). Incidence of preoperative anexiety in foriner was1.72 times of persion patients (OR=1.72) (0.99,4.25). The severity of anxiety was lower in boys (46.22 ± 6.68) compared with girls (52.55 ± 7.52) (P-value = 0.002) and lower in patients of medium-to-high socioeconomic status (43.64 ± 5.45) compared with those with lower socioeconomic status (49.66 ± 6.49) (P-value = 0.003). There was no relationship between being an only child and severity of anxiety (P-value = 0.54) (48.31 ± 5.05 vs. 48.12 ± 6.81). However, anxiety was more severe in patients with a history of hospitalization (50.55 ± 4.64) (49.2 ± 6.23) (P-value = 0.09). Severity of anexiety was not dependent to nationality of patients(P-value = 0.6) .Taken together, our data suggest that various methods should be used to reduce anxiety and associated complications, regarding the high prevalence of anxiety in mentioned groups of children and adolescents.
ABSTRACT
OBJECTIVES: Prevention and reduction of pain, anxiety, and fear during medical procedures is one of the most important factors that should be considered in pediatric emergencies. The aim of this study was to compare the efficacy of oral versus intranasal midazolam in sedation during radiologic imaging in the largest province of Iran, Kerman. MATERIALS AND METHODS: Eighty children were enrolled in this single-blind clinical trial based on convenience sampling and were divided into two groups receiving 0.5 mg/kg midazolam in oral route administration and 0.2 mg/kg midazolam in intranasal route administration. Finally, 75 patients remained for evaluating medication acceptability, sedation level, onset time of sedation, additional sedative dose, adverse effects of sedation, and provider satisfaction. RESULTS: Children in the intranasal group accepted medication more easily (89.8% vs. 36.9%; P ≤ 0.001), while these children received a lower sedation dose, but the sedation level in both methods was similar (P = 0.72). Our findings showed that children in the intranasal sedation group had a faster onset of sedation compared to the oral group (17.94 ± 8.99 vs. 34.50 ± 11.45; P ≤ 0.001). The frequency of midazolam side effects had no difference between the groups (29.7% vs. 15.8%; P = 0.15). CONCLUSION: Intranasal midazolam with a lower sedation dose induces a faster onset and better acceptance. Intranasal midazolam can be used as an effective sedative method for pediatric patients, especially in emergency wards.