Assessing Temperament as a Predictor of Distress at Anesthesia Induction Using the Children’s Behavior Questionnaire Short Form

Abstract

Purpose: To determine whether temperament as measured by the Children’s Behavior Questionnaire Short Form (CBQ-SF) is associated with distress at mask induction of general anesthesia (GA) for dental rehabilitation. Methods: Child-caregiver dyads were enrolled from physically healthy (ASA I-II) patients three to eight years old who received dental care under general anesthesia at an outpatient dental surgery center. Mask induction without any form of sedative premedication was utilized to induce GA in all patients. Inductions were video recorded, and scored for distress by two independent raters using a validated 10-point Induction Compliance Checklist (ICC). To assess child temperament, caregivers completed the CBQ-SF while waiting for the dental procedure to be completed. Chi-squared, Fisher’s exact, and Wilcoxon rank-sum tests were used to determine the relationship between temperament domains, demographic variables, and distress at induction. Results: Fifty-two child-caregiver dyads were enrolled in the study. Of these, 54% (n=28) of the children had perfect inductions (no disruptive behaviors). There was no statistically significant difference in perfect versus imperfect induction with respect to age, race, time of surgery, parent/guardian presence, insurance status, parental education level, employment or marital status, number of children in the household, pre-existing dental pain, or household food security. Female gender was significantly associated with imperfect induction (p=0.01). Conclusions: In this study there was no statistically significant relationship between temperament and patient compliance during general anesthesia induction. Parental presence did not improve induction compliance. Female patients were more likely to have disruptive behaviors at induction.