Effects of therapeutic suggestion in children undergoing general anesthesia

OBJECTIVES AND AIM: The goal of this randomized controlled trial was to examine the effect of intraoperative positive therapeutic suggestion on postoperative nausea and vomiting (PONV) in children undergoing general anesthesia and otolaryngological surgery.

BACKGROUND: Because of the high incidence of PONV following otolaryngological surgery and its negative impact on recovery, researchers have examined various nonpharmacological interventions to target this phenomenon. To date, the effectiveness of therapeutic suggestion has not been studied in children.

METHODS: Participants were 67 children undergoing tonsillectomy and adenoidectomy and their mothers. Children received a standardized anesthetic procedure and were randomly assigned to one of three interventions administered under general anesthesia: therapeutic suggestion, story (prosody control), or standard operating room noise. Children, parents, and healthcare personnel were blinded to group assignment. Nausea and vomiting were recorded in the postanesthesia care unit (PACU) and for the first 3 days at home.

RESULTS: Results demonstrated a decrease in nausea severity across the first 3 days, F(2,49) = 10.37, P < 0.001, but no group differences in nausea severity in the PACU (F(2,49) = 0.87, P = 0.43) or at home (F(2,49) = 0.80, P = 0.46). There were also no group differences in vomiting episodes in the PACU (chi(2) (2) = 1.25, P > 0.05) or at home (F(2,49) = 1.59, P = 0.21).

CONCLUSIONS: In this blinded controlled trial, therapeutic suggestion delivered intraoperatively did not impact children's PONV. However, because this is the first study of this kind, replication may be needed.

Paediatr Anaesth. 2010 Jan;20(1):90-9. Fortier MA, Weinberg M, Vitulano LA, Chorney JM, Martin SR, Kain ZN. Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA. mfortier@choc.org