The Impact of Maternal Sound on Awareness for Pediatric Patients Undergoing Cardiac Surgery
Condition: Intraoperative Awareness
MeSH terms: Intraoperative Awareness
Study type: Interventional

Summary: 
      Awareness during anesthesia with intraoperative memory occurs when the patient is able to
      process information and produce specific responses to several stimuli. Anecdotal evidence
      suggests that children exposed to therapeutic suggestion consisting of gently encouraging,
      positive words spoken to them during emergence from anesthesia seem to arouse after surgery
      with less agitation, less pain and lower requirements for pain medications. Therapeutic
      suggestion has been associated with positive results in some adults during surgery, but it is
      unknown how therapeutic suggestion affects children. A newborn's recognition and preference
      for their mother's voice occurs early in life, very likely during fetal development.
      Additional evidence, revealed that at least as early as 4 months of age, infants process
      auditory stimuli from their mother's voice at a higher amplitude than they process auditory
      input from female strangers, suggesting that maternal voice stimuli undergo a unique form of
      cerebral processing that lends support for the existence of neurophysiologic mechanisms that
      reflect a child's preference for his/her mother's voice. This study aims to evaluate and
      compare the possibility of intra-operative awareness prevention by using either music
      listening or maternal sound listening in children undergoing cardiac surgery.
    

Detailed description: 
      children (4 to 8 years) undergoing repair of Atrial Septal Defect (ASD). Patients will be
      randomized into two groups (music group and maternal sound group); in music group patients
      listened to a recorded CD by music and songs preferred by the child, while in maternal sound
      group patients listened to a recorded CD where the mother singing the most popular songs
      their children like or telling a story to their children. In both groups bi spectral index
      (BIS) to detect depth of anesthesia. An interview will be conducted with the patients and
      their parent within the first postoperative week by a semi-structured in-depth questionnaire
      to evaluate occurrence of awareness.
    

Intervention name(s): Music sound; Maternal sound
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The recorded preferred songs or music (commercially available) listened by CD player connected to the patient ears before induction of anesthesia and continued during intra operative period; The recorded maternal voice (while they are singing the most popular songs their children like or telling a story to help their children to sleep) listened by CD player connected to the patient ears before induction of anesthesia and continued during intra operative period
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Awareness; Cardiac Surgery; Maternal; Pediatric; Sound; Music