title: Effects of therapeutic suggestion in children undergoing general anesthesia: a randomized controlled trial.
abstract: OBJECTIVE
  The goal of this randomized controlled trial was to examine the effect of intraoperative positive therapeutic suggestion on postoperative nausea and vomiting (PONV) in children undergoing general anesthesia and otolaryngological surgery.
  
  
  BACKGROUND
  Because of the high incidence of PONV following otolaryngological surgery and its negative impact on recovery, researchers have examined various nonpharmacological interventions to target this phenomenon. To date, the effectiveness of therapeutic suggestion has not been studied in children.
  
  
  METHODS
  Participants were 67 children undergoing tonsillectomy and adenoidectomy and their mothers. Children received a standardized anesthetic procedure and were randomly assigned to one of three interventions administered under general anesthesia: therapeutic suggestion, story (prosody control), or standard operating room noise. Children, parents, and healthcare personnel were blinded to group assignment. Nausea and vomiting were recorded in the postanesthesia care unit (PACU) and for the first 3 days at home.
  
  
  RESULTS
  Results demonstrated a decrease in nausea severity across the first 3 days, F(2,49) = 10.37, P < 0.001, but no group differences in nausea severity in the PACU (F(2,49) = 0.87, P = 0.43) or at home (F(2,49) = 0.80, P = 0.46). There were also no group differences in vomiting episodes in the PACU (chi(2) (2) = 1.25, P > 0.05) or at home (F(2,49) = 1.59, P = 0.21).
  
  
  CONCLUSIONS
  In this blinded controlled trial, therapeutic suggestion delivered intraoperatively did not impact children's PONV. However, because this is the first study of this kind, replication may be needed.
authors.affiliation: Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA. mfortier@choc.org
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Fortier
authors.forename: Megan
authors.initials: M
authors.lastname: Weinberg
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Vitulano
authors.forename: Jill Maclaren
authors.initials: JM
authors.lastname: Chorney
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Martin
authors.forename: Zeev N
authors.initials: ZN
authors.lastname: Kain
mesh_terms: D000233:Adenoidectomy; D000768:Anesthesia, General / Q000523:psychology*; D001007:Anxiety / Q000523:psychology; D001066:Appetite / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D010290:Parents / Q000523:psychology; D011183:Postoperative Complications / Q000517:prevention & control / Q000523:psychology; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control* / Q000523:psychology; D018401:Sample Size; D013404:Suggestion; D013694:Temperament / Q000187:drug effects; D014068:Tonsillectomy