Emergence Delirium, Temperament
Conditions
Brief summary
The goal of this study is to determine if preoperative temperament is associated with postoperative pain, emergence agitation, emotional and behavioral changes, and overall parent satisfaction. This is a prospective observational study to assess preoperative temperament in pediatric patients undergoing tonsillectomy and adenoidectomy, gather demographic data, intraoperative data regarding surgical and anesthetic technique, and collect immediate postoperative data to assess pain, emergence agitation (EA), parental satisfaction as well as remote postoperative data to assess emotional and behavior changes. These data will be used to determine if patients with a specific temperament profile are more likely to experience increased pain, emergence agitation, emotional changes, and behavioral disturbances postoperatively.
Interventions
PROCEDURETonsillectomy and Adeniodectomy
pediatric patients undergoing tonsillectomy and adenoidectomy
Sponsors
Boston Children's Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
2 Years to 7 Years
Healthy volunteers
No
Inclusion criteria
* ASA I or II * undergoing Tonsil and/or Adenoid Removal at Boston Children's Hospital
Exclusion criteria
* history of prematurity * major chronic medical conditions * neurological impairment or developmental delay * parents/guardians who do not speak English or are unable to understand the questionnaires
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Temperament | preoperative period | Patient temperament based on the Children's Behavior Questionnaire. This is a 36 question temperament inventory completed by the caregiver. Items are scored on a scale from 1 to 7, where 1 is extremely untrue and 7 is extremely true. Total scores are linked to temperament constructs of Surgency, Negative Affectivity, and Effortful Control. |
| Pain score | immediately post operative period | Pain behavior to be recorded using numerical rating scale (NRS), FLACC scale or Wong Baker Faces scale as appropriate for age and developmental status. All of these scales are scored from 1-10 where higher scores indicate more pain. |
| emergence agitation | immediately post operative period | Measured using the Pediatric Emergence Delirium Scale (PAED). Scored on a scale from 0-4 where total scores of 10 or greater at any time during Post Anesthesia Care Unit (PACU) stay are classified as experiencing agitation. |
| post hospital behavior changes | up to 4 weeks after surgery | Measured using the Post Hospitalization Behavior Questionnaire. Questions are answered on a scale of 1-5, where 1 is less than before and 5 is more than before. Adverse behavioral outcomes to be defined as those patients who experienced behavioral changes at one or more standard deviations above the sample mean. |
Countries
United States
Contacts
Primary ContactStephen Kelleher, MD
Outcome results
None listed