Kim J E, Jo B Y, Oh H M, Choi H S, Lee Y
Department of Anaesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
J Int Med Res. 2012;40(4):1381-9. doi: 10.1177/147323001204000416.
This prospective, observational study aimed to identify children likely to require sedation preoperatively by measuring anxiety levels using the modified Yale Preoperative Anxiety Scale (mYPAS). Other possible predictive factors for preoperative sedation were also investigated.
A total of 455 patients aged 2-12 years scheduled for surgery requiring general anaesthesia were enrolled in the study. Patients' anxiety levels were measured using the mYPAS in a preoperative holding area just before patients were separated from their parents or guardians and entered the operating theatre. Anaesthetists blindedto the mYPAS assessments judged whether the child could be separated and enter the operating theatre without a sedative. The ability of the mYPAS to predict the need for preoperative sedation was analysed by receiver operating characteristic (ROC) curve analysis.
The optimum mYPAS cut-off for requiring sedatives was 41.7 according to ROC curve analysis. Multivariate logistic regression analysis showed that age, mYPAS>40 and waiting time were independent predictors of the requirement for sedative administration.
High anxiety levels, young age and long waits contributed to the need for preoperative sedation in children.
这项前瞻性观察性研究旨在通过使用改良耶鲁术前焦虑量表（mYPAS）测量焦虑水平，识别术前可能需要镇静的儿童。还对术前镇静的其他可能预测因素进行了调查。
本研究共纳入455例年龄在2至12岁、计划接受需要全身麻醉手术的患者。在患者与父母或监护人分开并进入手术室之前，于术前等候区使用mYPAS测量患者的焦虑水平。对mYPAS评估结果不知情的麻醉医生判断患儿在不使用镇静剂的情况下是否能够分开并进入手术室。通过受试者工作特征（ROC）曲线分析来分析mYPAS预测术前镇静需求的能力。
根据ROC曲线分析，使用镇静剂的最佳mYPAS临界值为41.7。多因素逻辑回归分析显示，年龄、mYPAS>40以及等待时间是镇静剂使用需求的独立预测因素。
高焦虑水平、年幼和长时间等待是导致儿童术前需要镇静的因素。
