Research to reduce children’s fears over surgery
RESEARCHERS FROM Yorkshire are launching a £1.7m study to investigate a new approach to calm anxious children before they are put to sleep for surgery.
The work led by experts in Sheffield will trial a safer alternative to existing drug treatment for nerves in youngsters ahead of operations for dental and ear, nose and throat-related problems.
As many as one in five undergoing the procedures – the most common reasons for children to have an anaesthetic in the UK – need medication to combat anxiety.
The team will replace an existing treatment using a sedative which carries the risk of side effects with medication already given to adults suffering from nerves.
Experts say if successful, the nationwide trial could lead to a change in practice by the NHS.
Figures show nearly 60,000 youngsters each year in the UK are put to sleep for dental procedures alone, most often for multiple extractions of rotten milk teeth.
Prof Chris Deery, a paediatric consultant at Sheffield University’s School of Clinical Dentistry and Sheffield teaching hospitals NHS trust, said tackling anxiety among children was a key part of overall treatment.
“The hospital anaesthetic room can be a worrying place for a child,” he said.
“An operation is never going to be a pleasant experience so it’s important to make it as pleasant as best we can. Reducing pre-operative anxiety can have a huge impact on a child’s hospital experience, improving recovery from the anaesthetic, reducing pain after surgery and avoiding the need for unnecessary re-appointments and delays to operations.”
He said anxiety might show itself weeks before surgery or on the day itself although it was not always obvious.
Parents might notice it if their child was behaving differently to normal.
“Parents are anxious themselves and sometimes children can pick up on that as well,” he said.
Children were offered reassurance and a chance to familiarise themselves with procedures to understand what was going to happen but in some cases they remained anxious and were typically given the sedative midazolam to calm them.
He said: “Although midazolam is an effective pre-medication for anxiety, it has many well-known side effects including loss of coordination and risks to breathing.
“Through this study we hope to improve the child’s overall experience by establishing if a safer, alternative pre-medication can be offered.”
Under the trial, patients will be given the drug melatonin, which has been shown to have some success in anxious adults, to see if it has fewer side effects. Prof Deery said the drug worked entirely differently. It was not a sedative so children would not feel drowsy but it had the affect of removing their anxiety. Researchers are looking to recruit more than 600 patients in the trial which will involve hospitals including Sheffield and Barnsley.