MacLaren Jill E, Thompson Caitlin, Weinberg Megan, Fortier Michelle A, Morrison Debra E, Perret Danielle, Kain Zeev N
Center for the Advancement of Perioperative Health, University of California, Irvine, California, USA.
Anesth Analg. 2009 Jun;108(6):1777-82. doi: 10.1213/ane.0b013e31819e74de.
In this investigation, we sought to assess the ability of pediatric attending anesthesiologists, resident anesthesiologists, and mothers to predict anxiety during induction of anesthesia in 2 to 16-yr-old children (n = 125).
Anesthesiologists and mothers provided predictions using a visual analog scale and children's anxiety was assessed using a valid behavior observation tool the Modified Yale Preoperative Anxiety Scale. All mothers were present during anesthetic induction and no child received sedative premedication. Correlational analyses were conducted.
A total of 125 children aged 2-16 yr, their mothers, and their attending pediatric anesthesiologists and resident anesthesiologists were studied. Correlational analyses revealed significant associations between attending predictions and child anxiety at induction (r(s) = 0.38, P < 0.001). Resident anesthesiologist and mother predictions were not significantly related to children's anxiety during induction (r(s) = 0.01 and 0.001, respectively). In terms of accuracy of prediction, 47.2% of predictions made by attending anesthesiologists were within one standard deviation of the observed anxiety exhibited by the child, and 70.4% of predictions were within two standard deviations.
We conclude that attending anesthesiologists who practice in pediatric settings are better than mothers in predicting the anxiety of children during induction of anesthesia. Although this finding has significant clinical implications, it is unclear if it can be extended to attending anesthesiologists whose practice is not mostly pediatric anesthesia.
在本研究中，我们试图评估儿科主治麻醉医生、住院麻醉医生和母亲预测2至16岁儿童（n = 125）麻醉诱导期间焦虑情绪的能力。
麻醉医生和母亲使用视觉模拟量表进行预测，儿童焦虑情绪使用有效的行为观察工具——改良耶鲁术前焦虑量表进行评估。所有母亲在麻醉诱导期间均在场，且无儿童接受镇静术前用药。进行了相关性分析。
共研究了125名2至16岁儿童、他们的母亲以及他们的儿科主治麻醉医生和住院麻醉医生。相关性分析显示主治医生的预测与诱导时儿童焦虑之间存在显著关联（r(s) = 0.38，P < 0.001）。住院麻醉医生和母亲的预测与诱导期间儿童焦虑无显著相关性（分别为r(s) = 0.01和0.001）。就预测准确性而言，主治麻醉医生做出的预测中有47.2%在儿童观察到的焦虑的一个标准差范围内，70.4%的预测在两个标准差范围内。
我们得出结论，在儿科环境中执业的主治麻醉医生在预测儿童麻醉诱导期间的焦虑方面比母亲更准确。尽管这一发现具有重要的临床意义，但尚不清楚这是否能推广到并非主要从事儿科麻醉的主治麻醉医生。
