Pediatric anesthesia & critical care
Analysis of Trajectories of Anxiety Behaviors During Induction of Anesthesia in Children With Multiple Encounters: A Secondary Analysis of a Multicenter Retrospective Cohort Study
Authors' conclusion
In this secondary analysis, we found that repeated anesthetic exposure did not inherently lead to sensitization. Instead, children-particularly in NORA settings-exhibited habituation, characterized by decreasing anxiety behaviors over time.
Study context
- Population
- Children <18 years undergoing induction of anaesthesia at six pediatric hospitals, 2019–202224,564 (24%) multiple encounters
- Participants
- 102,017 children
- Comparison
- Repeated anaesthetic encounters vs index visit
- Primary endpoint
- Trajectory of difficult induction (Child Induction Behavioral Assessment (CIBA) score of 3)
Methodological detailsmixed effects logistic regression
- Mixed effects logistic regression
Primary result
As reported in the abstract
Difficult induction across repeated encounters
- Prevalence stable during initial visits, decreased significantly after the fifth encounter; odds decreased by at least 30% vs index visit
- Adjusted for age, parental presence, and behavioral diagnoses
Secondary outcomes
Difficult induction by setting (subgroup)
- Children aged 1-12 years in Nonoperating room anesthesia (NORA) showed significant habituation; difficult induction rates in the OR remained static regardless of visit frequency
Anxiolytic strategy in high-frequency NORA utilizers
- Shift from pharmacological premedication to increased parental presence at induction
Original publication
Analysis of Trajectories of Anxiety Behaviors During Induction of Anesthesia in Children With Multiple Encounters: A Secondary Analysis of a Multicenter Retrospective Cohort Study. Paediatr Anaesth. Published 6 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →