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Sensory stimuli and anxiety in children undergoing surgery: a randomized, controlled trial
Z N Kain1, S M Wang, L C Mayes
1Department of Anesthesiology, Yale-New Haven Children's Hospital and Yale University School of Medicine, New Haven, Connecticut 06510, USA. kain@biomed.med.yale.edu
Insights
Low sensory stimulation, including dimmed lights and music, significantly reduced anxiety in children during anesthesia induction. This intervention also improved their cooperation, showing promising results for pediatric surgical care.
Area of Science:
- Pediatric Anesthesiology
- Behavioral Psychology
- Surgical Care
Background:
- Anxiety and fear are common in children undergoing anesthesia and surgery.
- Minimizing sensory stimuli may help alleviate distress during medical procedures.
Purpose of the Study:
- To assess the effectiveness of a low sensory stimulation intervention in reducing anxiety in children during anesthesia and surgery.
- To evaluate the impact of dimmed lights, soft music, and a single caregiver on pediatric patient anxiety and compliance.
Main Methods:
- A randomized controlled trial was conducted with two groups: low sensory stimulation (LSSG) and control.
- The LSSG experienced dimmed OR lights, classical music, and interaction with only one anesthesiologist.
- Anxiety and compliance were measured using validated scales (mYPAS, ICC) during anesthesia induction.
Main Results:
- Children in the LSSG showed significantly lower anxiety levels upon entering the OR and when introduced to the anesthesia mask.
- Improved compliance during anesthesia induction was observed in the LSSG compared to the control group.
- No significant difference in postoperative behavioral changes was found between the groups.
Conclusions:
- A low sensory environment with music and limited interaction effectively reduces pre-anesthetic anxiety in children.
- This intervention enhances cooperation during anesthesia induction, improving the pediatric surgical experience.
Unlabelled:
We assessed the effectiveness of a behavioral intervention aimed at reducing the anxiety of children undergoing anesthesia and surgery. The intervention consisted of dimmed operating room (OR) lights (200 Lx) and soft background music (Bach's "Air on a G String," 50-60 dB). Only one person, the attending anesthesiologist, interacted with the child during the induction of anesthesia. Children undergoing anesthesia and surgery were randomly assigned either to a low sensory stimulation group (LSSG, n = 33) or to control group (n = 37). By using validated behavioral measures of anxiety (mYPAS) and compliance (ICC), children were evaluated at the preoperative holding area and during the induction of anesthesia. On postoperative Days 1, 2, 3, 7, and 14, the behavioral recovery of the children was assessed by using the Post Hospitalization Behavior Questionnaire. We found that the LSSG was significantly less anxious compared with the control group on entrance to the OR (P = 0.03) and on the introduction of the anesthesia mask (P = 0.003). Also, the compliance during the induction of anesthesia was significantly better in children assigned to the LSSG (P = 0.02). The incidence of postoperative behavioral changes, however, did not differ significantly between the two groups (P = ns). We conclude that children who are exposed to low-level sensory stimuli during the induction of anesthesia and who are exposed to background music exhibit lower levels of anxiety and increased compliance.
Implications:
Children are less anxious and show increased compliance during induction when exposed to a single care-provider in a dimmed, quiet operating room with background music.
