Anaesthesia
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Adults who experience intra-operative awareness can develop disturbing long-lasting after-effects, such as daytime anxiety, sleep disturbances, nightmares, flashbacks and, in the worst case, a post-traumatic stress disorder (PTSD). It is unknown whether intra-operative awareness has a similar psychological impact in children. We designed the present study in order to evaluate the incidence of psychological symptoms in children who had either confirmed or possible intra-operative awareness. ⋯ In contrast with what has been reported in adults, these children claimed not to have experienced major pain, terror or helplessness during their surgery. Despite the small sample size, the results of the present study suggest that children suffer less psychological sequelae than adults following intra-operative awareness. This may be due to the fact that the children reported less frightening intra-operative sensations as compared with the adults, and had less understanding of the anaesthesia procedure, and this may have influenced their appraisal of their awareness and protected them from the full impact of this potentially traumatic experience.
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In this prospective study, we investigated the effects of anxiety on the induction dose of propofol and subsequent cardiovascular changes in 197 patients. Pre-operative state and trait anxiety scores were measured using the State Trait Anxiety Inventory. Propofol was administered at 40 mg x kg(-1) x h(-1). ⋯ Maximum percentage decreases in heart rate and mean arterial pressure, and the point at which the latter occurred, were recorded. On multivariate analysis, anxiety scores did not significantly affect propofol dose or cardiovascular end-points, although Bispectral Index at loss of verbal response decreased with increasing trait anxiety (p = 0.02). Anxiety, measured using State Trait Anxiety Inventory, does not appear independently to affect the induction characteristics of propofol.