NCT00581139

Brief Summary

The primary hypothesis tested in this project is that the preoperative behavioral stress response predicts postoperative behavioral and clinical recovery of children undergoing surgery.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
241

participants targeted

Target at P75+ for phase_2

Timeline
Completed

Started Apr 2003

Longer than P75 for phase_2

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

April 1, 2003

Completed
4.7 years until next milestone

First Submitted

Initial submission to the registry

December 18, 2007

Completed
9 days until next milestone

First Posted

Study publicly available on registry

December 27, 2007

Completed
1.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2009

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2009

Completed
14.4 years until next milestone

Results Posted

Study results publicly available

September 7, 2023

Completed
Last Updated

September 7, 2023

Status Verified

August 1, 2023

Enrollment Period

6 years

First QC Date

December 18, 2007

Results QC Date

June 3, 2021

Last Update Submit

August 25, 2023

Conditions

Outcome Measures

Primary Outcomes (8)

  • Modified Yale Preoperative Anxiety Scale

    The Modified Yale Preoperative Anxiety Scale (mYPAS) is the current "criterion standard" for assessing child anxiety during induction of anesthesia and has been used in \>100 studies. This observational instrument covers 5 items and is typically administered at 4 perioperative time points. Minimum value is 23.33 and maximum value is 100. Scores below 30 are considered low anxiety. Score of 30 or more is considered high anxiety.

    Day of surgery

  • Percentage of Children Not Exhibiting Negative Behaviors, Fear, or Anxiety (Perfect Induction, 0)

    A total score is the number of categories checked (1-10). A perfect induction is when a patient does not exhibit negative behaviors, fear, or anxiety. A perfect score would be 0. icc 1 = Crying, tears in eyes icc 2 = Turns head away from mask icc 3 = Verbal refusal, says "no" icc 4 = Verbalization indicating fear or worry, "Where's mommy?" or "Will it hurt?" icc 5 = Pushes mask away with hands, pushes nurse/anesthesiologist with hands/feet icc 6 = Covers mouth/nose with hands/arms or buries face icc 7 = Hysterical crying, may scream icc8 = Kicks/flails legs/arms, arches back, and/or general struggling icc9 = Requires physical restraint icc10 = Complete passivity either rigid or limp icc 0 = Perfect induction

    Induction, up to 10 minutes

  • Percent of Children Crying During Induction

    Children who were crying/ had tears in their eyes during induction.

    Induction, up to 10 minutes

  • Percentage of Children Arriving to PACU Awake

    Whether child arrived to PACU awake Emergence of 1 // whether child arrived to PACU awake

    Arrival at PACU, after surgery up to 20 minutes

  • Percentage of Children Arriving to PACU in Deep Sleep

    Whether child arrived to PACU awake Emergence of 2 // whether child arrived to PACU in deep sleep

    Arrival at PACU, after surgery up to 20 minutes

  • Post Anesthesia Care Unit (PACU) IV Fluid

    Total IV fluid per kg in PACU

    Post Anesthesia Care Unit up to 2 hours

  • Visual Analogue Pain Scale (VAS) 24 Hour After Surgery

    Parent-ranted child pain on the Visual Analogue Scale. The VAS for pain is a unidimensional measure of pain presented in a horizontal line from 0-100. A higher score indicates greater pain intensity. 0-4= no pain/anxiety, 5-44= mild pain/anxiety, 45-74 = moderate pain/anxiety, 75-100 = severe pain/anxiety.

    24 Hours after surgery

  • Heart Rate in the General Clinical Research Unit (GCRC)

    Heart rate was measured in the GCRC by the nurse hours 0 through 6 after Surgery

    Hour 0-6 after surgery

Study Arms (4)

1

ACTIVE COMPARATOR
Behavioral: Preoperative Preparation Program (Child Life Specialist)

2

ACTIVE COMPARATOR
Drug: Midazolam

3

ACTIVE COMPARATOR
Behavioral: Parental Presence during Induction of Anesthesia

4

ACTIVE COMPARATOR
Other: PPIA preparation program PLUS Midazolam premedication

Interventions

This group will receive the standard preoperative visit to the hospital with Child Life intervention

1

0.5 mg/kg oral midazolam

Also known as: Versed
2

One parent will be present during induction of anesthesia of the child. The parent will be accompanied out of the OR by a nurse once the induction is completed. These parents will have completed a parent preparation program.

Also known as: PPIA Preparation Program
3

Subjects in this group will receive both interventions 2 and 3.

4

Eligibility Criteria

Age3 Years - 12 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • Outpatient tonsillectomy or tonsils/adenoids
  • ASA I, II

You may not qualify if:

  • Developmental delay
  • ASA III-IV
  • Psychotropic medication
  • Meds which interfere with metabolism of midazolam
  • weeks gestation

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Yale University Department of Anesthesiology

New Haven, Connecticut, 06510, United States

Location

MeSH Terms

Conditions

Pain, Postoperative

Interventions

Allied Health PersonnelMidazolam

Condition Hierarchy (Ancestors)

Postoperative ComplicationsPathologic ProcessesPathological Conditions, Signs and SymptomsPainNeurologic ManifestationsSigns and Symptoms

Intervention Hierarchy (Ancestors)

Health PersonnelHealth Care Facilities Workforce and ServicesBenzodiazepinesBenzazepinesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic Compounds

Results Point of Contact

Title
Dr. Zeev Kain
Organization
University of California, Irvine

Study Officials

  • Zeev N Kain, MD, MBA

    Yale University Department of Anesthesiology

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

December 18, 2007

First Posted

December 27, 2007

Study Start

April 1, 2003

Primary Completion

April 1, 2009

Study Completion

April 1, 2009

Last Updated

September 7, 2023

Results First Posted

September 7, 2023

Record last verified: 2023-08

Locations