New research suggests that allowing children to use iPads before surgery is at least as effective at lowering anxiety as traditional pre-op sedatives.
The study authors, from Hôpital Femme Mère Enfant in Lyon, compared the effects of midazolam (a sedative regularly used before general anaesthesia) with iPad game apps in children between the ages of four and 10 during and after day surgery. Anxiety was assessed in both children and their parents.
Child anxiety was measured by two independent psychologists at four points: on arrival at hospital, at separation from the parents, during induction and in the post anaesthesia care unit. Parental anxiety was measured at the same points (except induction as they were not present). Anaesthetic nurses ranked from zero (not satisfied) to 10 (highly satisfied) the quality of induction of anaesthesia.
The researchers found similar anxiety levels in parents and children, when compared with patients who took midazolam. But induction quality was found to improve with the presence of an iPad.
The study’s lead author, Dr Dominique Chassard, said: ‘Our study showed that child and parental anxiety before anaesthesia are equally blunted by midazolam or use of the iPad.
‘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.’
It is well known that distraction therapy — whether listening to music, reading or playing games — can reduce the worry and anxiety associated with having a medical procedure. This small trial simply adds iPads to the tools that can be used here as an extra way of reducing children’s anxiety before having a surgical procedure.
It may be some time yet before all hospitals use online gaming or virtual reality in children’s wards as a way of helping minimise the need for sedating medication pre-operatively, but what this shows is the evolution of distraction therapy into the digital age. The study size is tiny — just over 100 children — but larger trials will not add to what we already know: children’s anxiety can be reduced by distracting them.