Aanesthetic Agents for Day Surgery - NIHR Health Technology ...

TABLE 69 contd Summary of paediatric patient-based outcomes studies
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Health Technology Assessment 2002; Vol. 6: No. 30
Study Investigations Outcome Results Conclusions and Reviewers’ comments
and subjects measures grade of evidence (grade of evidence and
checklist criteria)
Scaife and Day patients Five-point scale There were few significant The results show Grade I
Campbell, (34) vs using various differences in the magni- trends in favour of
1988, 204 UK inpatients (27) descriptors, tude or direction of day procedures; the RCT, no blinding
derived from a change between the day- argument is made that
RCT Children’s standardised patient and inpatient day procedures should No significant changes in
behaviour behaviour groups; no significant be the preferred option behaviour between day
screening device. differences were found for minor surgery in patients and inpatients.
Parents rated between day patients and young children Difficult to draw a
their own inpatients on the post- conclusion
subjective discharge ratings or at
anxiety about 3 months follow-up
different aspects
Selby et al., 266 children PONV, sore PONV 53%, sore throat Personal interviews Unrepresentative sample,
1996, 205 UK (aged 5 years throat, visual 31%, visual disturbance with children revealed as only 10% of the sample
and over) were disturbance, 25%, headache 19%, a higher incidence of agreed to be interviewed.
Descriptive interviewed by headache, shivering 13%, bad minor morbidity However, the results
survey an anaesthetist shivering, dreams 4% following day surgery were significant
about minor bad dreams than had been
sequelae after previously reported
day surgery.
10% of patients
were interviewed
Sikich et al., Evaluation Postal Extreme concern 5% of parents expected Grade IV
1997, 206 Canada of parental questionnaire expressed for pain (45.5%). their child to be active
perceptions, 28.7% had postoperative and alert in the first Survey design
Survey expectations vomiting. Pain vs sleepi- 24 h after surgery;
and preferences ness, p < 0.0001; pain vs 22.8% preferred Unclear what questions
for post- vomiting, p < 0.02 quicker postanaesthetic were asked in the
anaesthetic recovery; speed of questionnaire
recovery of discharge was not a
children priority for parents;
parents were concerned
about postoperative
pain and postoperative
vomiting
Tarbell et al., Evaluation of TPPPS and a Scores on the TPPPS were The TPPPS was found Grade IV
1992, 207 USA the reliability VAS scale in the range 0–7. The to have satisfactory
and validity of variability in the TPPPS internal reliability.The Observational study
Observational the TPPPS scores appears acceptable inter-rater reliability
study in spite of the negative was good, with κ values Further study is indicated
skew, given that the for pain behaviour to specifically control for
surgical procedures evalu- items ranging from analgesic factors that may
ated were not the most 0.53 to 0.78 have complicated the
painful procedures that interpretation of the TPPPS
a young child may undergo. scores (e.g. the sedative
Inter-rater reliability checks properties of analgesic
were conducted for 38% medications)
of children
continued
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