Allowing children to use iPads to distract them before surgery requiring general anaesthesia is as effective at lowering their anxiety as conventional sedatives, a new study has claimed. Researchers found that parental satisfaction and quality of anaesthesia induction was higher in children using iPads.
Mobile interactive tools have been found to be effective to reduce child anxiety at parental separation in the operating theatre, researchers said.
The study by Dr Dominique Chassard, from Hopital Mere Enfant, Hospices Civils de Lyon in France and colleagues compared the effects of midazolam (a sedative used regularly before anaesthesia) in premedication with age-appropriate game apps (on an iPad tablet) on children aged 4-10 years during and after ambulatory (day) surgery.
Anxiety was assessed both in children and in parents.
As many as 54 children were randomly allocated to MDZ (midazolam) group and 58 children to TAB (iPad) group.
Patients in group MDZ received midazolam 0.3mg/kg orally or rectally, and group TAB were given an electronic tablet (iPAD) 20 min before anaesthesia.
Child anxiety was measured by two independent psychologists at four time points: at arrival at hospital, at separation from the parents, during induction and in the post anaesthesia care unit (PACU). Parental anxiety was measured at the same time points except during induction as they were not present at that point.
Anaesthetic nurses ranked from 0 (not satisfied) to 10 (highly satisfied) the quality of induction of anaesthesia.
The researchers found both parental and child anxiety levels to be similar in both groups, with a similar pattern of evolution. Both parents and nurses found anaesthesia more satisfying in the iPad group. "Our study showed that child and parental anxiety before anaesthesia are equally blunted by midazolam or use of the iPad," said Chassard. "However, the quality of induction of anaesthesia, as well as parental satisfaction, were judged better in the iPad group. Use of iPads or other tablet devices is a non-pharmacologic tool which can reduce perioperative stress without any sedative effect in paediatric ambulatory surgery," said Chassard.
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