The Effect of Preoperative Counseling on Emergence Agitation in Patients Candidate for Nasal Surgeries : a Prospective Randomized Controlled Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Cairo University
- Enrollment
- 256
- Locations
- 1
- Primary Endpoint
- The incidence of emergence agitation using AONO s scale(percentage of patients having score of 3 or 4)
Study Overview
Brief Summary
Emergence agitation is a post anesthetic phenomenon that develops in the early phase of general anesthesia recovery,The aim of our study to investigate the effect of preoperative educational counselling of the patient undergoing nasal surgery on emergence agitation .
Detailed Description
While its pathogenesis remains unclear, previous studies reported that ENT (ear, nose, and throat) surgical procedures have a higher incidence of emergence agitation in both adults and children. Especially, our clinical impression is that nasal surgical patients admitted to the postbanesthesia care unit (PACU) have suffered emergence agitation more frequently than other surgical patients, possibly due to a sense of suffocation during emergence from anesthesia.
preoperative counselling and repeated verbal stimulation of orientation may serve as a simple and easily applicable strategy to reduce emergence agitation after general anaesthesia .
There have been studies looking into the effect of pre-operative counselling on individual aspects internationally like anxiety, BMI, serum cholesterol , length of stay , pain .( Six trials were identified and have produced conflicting findings. Some trials have demonstrated the effects of preoperative education on improving physical and psychosocial recovery of cardiac patients, while others found no evidence that patients' anxiety is reduced or of any effect on pain or hospital stay) .
To our knowledge there was no study investigating the impact of preoperative counselling on postoperative agitation following nasal surgeries, The aim of our study to investigate the effect of preoperative educational counselling of the patient undergoing nasal surgery on emergence agitation .
Study Design
- Study Type
- Observational
- Observational Model
- Case Control
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 21 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Both genders.
- •Patients undergoing nasal surgery
- •American Society of Anesthesiologist (ASA) I or II physical status.
- •Between 18 and 65 years of age.
Exclusion Criteria
- •● Patients with communication difficulties.
- •ASA Ⅲ and Ⅳ patients.
- •Mentally retarded patients.
- •In-ability to postpone anti-coagulation medications.
- •Central or peripheral neurological disease.
- •Drug or alcohol abuse.
- •Localized infection at nose.
- •Bleeding disorder (platelets count less than 100,000 or INR more than 1.4)
Arms & Interventions
- Group A
Will ask them to close their nose completely by their hands and take their breath only from the mouth for 2 to 3 minutes before induction of GA.
: immediately after extubation we will tell them many times at their ear that the operation has been finished and ask them to take their breath from the mouth as they counselled and trained at preoperative period
● Group B
Will start the induction of anesthesia without any preoperative counselling of nasal closure .
this group will undergo extubation and should be instructed to use their nose for breathing without Without preoperative counselling
Outcomes
Primary Outcomes
The incidence of emergence agitation using AONO s scale(percentage of patients having score of 3 or 4)
Time Frame: scale immediately after extubation and then every 5 minutes for 20 minutes
● AONO s four point agitation scale The scale is decribed as 1 = calm; 2 = not calm but could be easily calmed; 3 = not easily calmed, moderately agitated or restless; and 4 = combative, excited, or disoriented.
Secondary Outcomes
- heart rate in beats per minute(immediately after extubation and then every 5 minutes for 20 minutes)
- systolic blood pressure in mmhg(immediately after extubation and then every 5 minutes for 20 minutes)
- mean blood pressure in mmhg(immediately after extubation and then every 5 minutes for 20 minutes)
- oxygen saturation in %(immediately after extubation and then every 5 minutes for 20 minutes)
Investigators
Maged Abdel-Wahab Abdel-Aziz
pricipal investigator
Cairo University