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This project will investigate whether reduction in ambient light and elimination of noise on induction of anesthesia alters anxiety (modified Yale Preoperative Anxiety Scale or mYPAS) or compliance (induction compliance checklist or ICC scoring), alters recovery following emergence using pain scores, analgesic requirements, and emergence delirium (post anesthesia emergence delirium or PAED), or post-discharge behavior at 1, 7 and 14 days (modified post hospitalization behaviour questionnaire or PHBQ) in patients who receive anxiolytic premedication. In addition, the investigators will assess the cumulative level of nose exposure that patients experience during the perioperative period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Noise reduction | Experimental | Reduced operating room personnel, low ambient light and soft background music during induction and emergence from anesthesia. |
|
| Control | No Intervention | Normal operating room environment. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Noise reduction | Other | All activity will cease when the patient enters the operating room and nonessential personnel will be removed. Ambient lighting will be reduced and communication devices muted. |
| Measure | Description | Time Frame |
|---|---|---|
| Anxiety during induction | A blinded observer will assess behavior prior to and during induction/placement of face mask or insertion of an intravenous line using the mYPAS scale. | First 5 minutes of surgical procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Compliance during induction | A blinded observer will assess behavior prior to and during induction/placement of face mask or insertion of an intravenous line using the ICC scale. | First 5 minutes of surgical procedure |
| Presence of post anesthesia emergence delirium |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Richard Cartabuke, MD | Nationwide Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nationwide Children's Hospital | Columbus | Ohio | 43205 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39185368 | Derived | Bozych M, Tram NK, Rice-Weimer J, Cartabuke RS, Tobias JD, Huffman J, Mpody C, Uffman JC. Operating Room Noise Environment and Behavior in Children Undergoing General Anesthesia: A Randomized Controlled Trial. Anesthesiol Res Pract. 2024 Aug 16;2024:4838649. doi: 10.1155/2024/4838649. eCollection 2024. |
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Following transfer to the post anesthesia care unit (PACU) from the OR, the PAED scale will be measured every 10 minutes from arrival until discharge from PACU. |
| Average of 30 mins - 1 hr |
| Post-discharge behavior disturbances | Parents will be contacted by phone and asked a series of 11 questions (PHBQ) to assess participants behavior following surgery. | Post-op day 1 |
| Post-discharge behavior disturbances | Parents will be contacted by phone and asked a series of 11 questions (PHBQ) to assess participants behavior following surgery. | Post-op day 2 |
| Post-discharge behavior disturbances | Parents will be contacted by phone and asked a series of 11 questions (PHBQ) to assess participants behavior following surgery. | Post-op day 7 |
| Noise exposure | Assess the peak and cumulative level of noise exposure to the patient during the entire surgery. | Average of 30 mins - 3 hrs |