Trends in the practice of parental presence during induction of anesthesia and the use of preoperative sedative premedication in the United States, 1995-2002: results of a follow-up national survey.
Both parental presence during induction of anesthesia and sedative premedication are currently used to treat preoperative anxiety in children. A survey study conducted in 1995 demonstrated that most children are taken into the operating room without the benefit of either of these two interventions. In 2002 we conducted a follow-up survey study. Five thousand questionnaires were mailed to randomly selected physician members of the American Society of Anesthesiologists. Mailings were followed by a nonresponse bias assessment. Twenty-seven percent (n = 1362) returned the questionnaire after 3 mailings. We found that a significantly larger proportion of young children undergoing surgery in the United States were reported to receive sedative premedication in 2002 as compared with 1995 (50% vs 30%, P = 0.001). We also found that in 2002 there was significantly less geographical variability in the use of sedative premedication as compared with the 1995 survey (F = 8.31, P = 0.006). Similarly, we found that in 2002 parents of children undergoing surgery in the United States were allowed to be present more often during induction of anesthesia as compared with 1995 (chi(2) = 26.3, P = 0.0001). Finally, similar to our findings in the 1995 survey, midazolam was uniformly selected most often to premedicate patients before surgery.


CONCLUSIONS
Over the past 7 yr there have been significant increases in the number of anesthesiologists who use preoperative sedative premedication and parental presence for children undergoing surgery.
Kain
Zeev N
ZN
Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06510, USA. kain@biomed.med.yale.edu
Caldwell-Andrews
Alison A
AA
Krivutza
Dawn M
DM
Weinberg
Megan E
ME
Wang
Shu-Ming
SM
Gaal
Dorothy
D
D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000523:psychology*; D015982:Bias; D002648:Child; D003625:Data Collection; D004363:Drug Utilization; D005260:Female; D005500:Follow-Up Studies; D006279:Health Maintenance Organizations; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D010290:Parents / Q000523:psychology*; D011229:Preanesthetic Medication / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States
D006993:Hypnotics and Sedatives