Title: Improving access to preparatory information for children undergoing general anaesthesia for surgical dental procedures and their families
Funder: Department of Health (England)

Abstract: Background Preoperative anxiety in children is associated with distress at anaesthesia induction and postoperative psychological and physical morbidity. Preparation programmes for anaesthesia are highly effective in reducing preoperative distress, however, their wide implementation lags behind. A prototype computer package providing interactive information for children undergoing anaesthesia for surgical dental procedures has proven to reduce distress; but it isn’t available to patients outside of the research context yet. The key characteristics of the intervention include: modelling appropriate behaviour, coping skill teaching, and parent involvement. Children having teeth out are the biggest users of general anaesthesia- better preparation will improve their experience and services NHS-wide. Aims Will internet delivered information help children cope better with anaesthesia? Primary: To scrutinise the effectiveness of an internet based preparatory information package against standard care, in respect to: (1)patient experience:-acceptance of anaesthetic induction; child co-operation; reduction of peri and post operative morbidity; child and family satisfaction;(2)service improvement:-anaesthetic time/improvement in throughput. Secondary: A. To evaluate the accessibility, usability/functionality and acceptability of this type of patient information resource. B. To understand the mechanism of action of the computer package. Plan of Investigation 1: Update the prototype so that it is suitable for the internet, with user group help to ensure it is fit for purpose. 2: Scrutinize the efficacy and usability of the internet package in 5-7 year old children undergoing GA for dental extractions. A clinical trial in 210 children will compare the internet version of the package against standard care and a non-medical computer game. Pre- and post operative distress will be assessed through evaluation of the child’s behaviour during the visit and parental reports of physical and psychological morbidity. The views of parents and children will be sought; the mode of usage of the internet package will be automatically recorded and the impact on the service e.g. recovery time and throughput will be reported. Potential Impact Preparatory information benefits patients. This study will be the first to test whither interactive internet material helps families to better, and more conveniently, prepare a child for surgery. We intend to focus on child dental patients because this: (1) is the most common group referred for general anaesthesia in the UK yet has the least ‘user friendly’ care pathway, (2) avoids sample variation in respect to anaesthetic method and surgery type, (3) is the service that will benefit most by reduction in family and staff stress and by resultant increase in throughput. However, in future, package access can be easily expanded UK-wide and the information gained used to develop further resources for children and adults who require other medical procedures, such as blood tests.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: ORAL AND GASTROINTESTINAL