Anxiety during inhalation induction in paediatrics: Sitting versus supine position, a randomised trial

Abstract

Study objective: We evaluated if the sitting or supine positions affect anxiety levels induced by the application of a facemask in children.

Design: Prospective, randomised study.

Setting: Paediatric hospital, operating room.

Patients: Two to twelve years old children, 1-3 ASA status, undergoing inhalation anaesthesia for elective surgery.

Intervention: Children were randomly assigned to a sitting or supine position. After monitoring equipment was established, inhalation was inducted by the application of the mask.

Measurements: Child anxiety was then assessed with the modified Yale Preoperative Anxiety Scale (mYPAS) before the application of the facemask and following mask application.

Main results: Overall, 99 children in the sitting group and 103 in the supine group were analysed. The mYPAS score was not different in both groups before the application of facemask (40 [28-51] versus 40 [28-53]; P=0.99). It increased (P=0.005) to a similar extent in both groups following mask application without difference between groups (48 [38-60] versus 48 [35-63]; P=0.95). Side effects were not different between both groups.

Conclusion: In children undergoing inhalation induction, sitting or supine positions did not modify anxiety induced by the application of a facemask, nor adverse effects; therefore, children should be allowed to choose their preferred position.

Keywords: Anxiety; Inhalation anaesthesia; Mask; Paediatric anaesthesia; Sitting position.