mERAS Intervention, The ASA (American Society of Anesthesiologists) Score, The Patient Must be Between 4 and 12 Years Old
Conditions
Keywords
Pediatric laparoscopic surgery, ERAS, Postoperative Recovery
Brief summary
Pediatric laparoscopic surgery is a gold standard across all ages, offering benefits like smaller incisions, faster recovery, and better cosmetic outcomes. However, because children require more precise hemodynamic and respiratory management than adults, specialized perioperative care is essential. This study aims to evaluate the impact of a multidisciplinary Enhanced Recovery After Surgery (ERAS) approach on children aged 4-12, specifically measuring its effect on postoperative pain, nausea, thirst, fear levels, and the overall recovery process.
Interventions
OTHERmERAS Protocol
mERAS Protocol Patient Group 1. Preoperative Period: Preparation and Education Within the scope of the mERAS protocol, both the child and their family are evaluated with a holistic approach in the preoperative period and prepared for the surgical process; this process is structured in accordance with the current ERAS guidelines for pediatric applications. Education and Counseling The child and their family will receive detailed information covering the preoperative, intraoperative, and postoperative processes. The child will be educated on preparing for the surgical experience using age-appropriate audiovisual materials; the family will be informed about the basic components of the recovery process, expected outcomes, and the contributions of the ERAS protocol. In addition, regular internal training for the surgeon, nurses, and anesthesia team will be provided to increase the applicability of the protocol and team cohesion. Preoperative Interventions • Patient and Family Information: P
Sponsors
Emel Yürük
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Subject)
Intervention model description
This research was planned as a parallel-group, randomized controlled experimental study based on pre-test-post-test measurements to evaluate the effect of the Accelerated Recovery (mERAS) approach on postoperative pain, nausea-vomiting, thirst, fear, and recovery process in children undergoing pediatric laparoscopic surgery.
Eligibility
Sex/Gender
ALL
Age
6 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* The patient must be between 4 and 12 years old, * The ASA (American Society of Anesthesiologists) score must be 1 or 2, * The parent(s) must be cognitively competent to give consent.
Exclusion criteria
* The child/parents must refuse to participate in the study, * The presence of comorbidities that interfere with mobilization or oral feeding (which impairs the pain score), * Chronic pain syndrome or regular opioid use, * Previous major surgery in the same area (which may affect healing and pain experience).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Wong-Baker Faces Pain Rating Scale | 7 DAY | Wong-Baker Faces Pain Rating Scale (Appendix 2): This is a visual self-assessment tool developed to evaluate the physical pain levels of individuals aged three years and older based on their own reports. The scale, consisting of six facial expressions, is scored from 0 = "no pain" to 10 = "very severe pain," and the child is asked to choose the face that best expresses the pain they are experiencing. It is a frequently used, valid, and understandable method for evaluating acute pain, especially in children who have difficulty verbally describing pain (Wong \& Baker, 1988; Cohen et al., 2008). In this study, the postoperative pain levels of all children in the 4-12 age group will be evaluated using the Wong-Baker Faces Pain Rating Scale. In each measurement, the facial expressions will be explained to the children according to the standard instructions of the scale, and they will be asked to choose the face that best reflects the pain they are experiencing. The visual form of the scale |
| Baxter Animated Retching Faces Scale (BARF) | 7 days | The Baxter Animated Retching Faces (BARF) Scale, developed by Baxter et al., is a self-report tool that assesses the severity of nausea using six-stage visual facial expressions ranging from "no nausea" to "severe nausea/vomiting." The faces on the scale are ordered to represent increasing levels of nausea (Baxter et al., 2011; Şişman et al., 2016). |
| Visual Thirst Scale | 7 days | Visual Thirst Scale: The Visual Analog Scale (VAS) will be used to assess the severity of thirst in the postoperative period. On this scale, a value of 0 represents "no thirst" and a value of 10 represents "the most severe thirst the patient has ever felt." This approach is consistent with the method used by Conchon and Fonseca in their perioperative thirst studies to quantitatively assess the subjective severity of thirst (Conchon \& Fonseca, 2015). |
| Children's Fear Scale | 7 days | Children's Fear Scale: by McMurtry et al. (2011), the Children's Fear Scale is a visual self-assessment scale consisting of five facial expressions, scored between "no fear" (0) and "very frightened facial expression" (4), used to assess the level of fear experienced by children during medical procedures. The adaptation and validity-reliability study of the scale into Turkish was carried out by Gerçeker et al. (2018). No permission is required for clinical and research use of this scale (Children's Fear Scale - https://www.uoguelph.ca/pphc/childrens-fear-scale). |
Outcome results
None listed