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The effect of play distraction on anxiety before premedication administration: a randomized trial
Gözde Bumin Aydın1, Serhat Yüksel2, Jülide Ergil1
1Ministry of Health Dıskapı Research and Training Hospital Anesthesiology and Reanimation Clinic, Ankara, Turkey.
Insights
Playing with play dough significantly reduced preoperative anxiety in children before receiving midazolam. This distraction technique improved the administration of oral midazolam, making the experience less stressful for young surgical patients.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Surgical Patient Care
Background:
- Children experience significant preoperative anxiety before surgery.
- Pharmacological anxiety reduction methods can cause stress.
- Oral midazolam, a common premedication, has a bitter taste in Turkey.
Purpose of the Study:
- To evaluate the effectiveness of play dough distraction in reducing preoperative anxiety in children.
- To assess the impact of play dough on the administration of oral midazolam.
Main Methods:
- Prospective randomized clinical trial involving 104 children aged 3-7 years.
- Children were randomized to receive play dough (group PD) or no distraction (group C) before oral midazolam.
- Premedication anxiety was measured using the modified Yale Preoperative Anxiety Scale (mYPAS).
Main Results:
- No significant difference in anxiety scores (mYPAS) between groups at baseline (T0).
- Group PD showed significantly lower mYPAS scores at T1 and T2 compared to group C (P<.001).
- In group PD, anxiety scores significantly decreased from T0 to T1 and T2 (P<.001).
Conclusions:
- Distraction with play dough effectively reduces premedication anxiety in young children.
- Play dough facilitates the administration of oral midazolam, improving the preoperative experience.
Study Objective:
The majority of children scheduled to undergo surgery experience substantial anxiety in the preoperative holding area before induction of anesthesia. Pharmacological interventions aimed at reducing perioperative anxiety are paradoxically a source of stress for children themselves. Midazolam is frequently used as premedication, and the formula of this drug in Turkey is bitter. We aimed to assess the role of distraction in the form of playing with play dough (Play-Doh) on reducing premedication anxiety in children.
Design:
Prospective randomized clinical trial.
Setting:
Preoperative holding area.
Patients:
One hundred four healthy children aged 3 to 7 years scheduled to undergo elective surgery were enrolled into the study.
Interventions:
All children routinely receive sedative premedication (oral midazolam) before anesthesia. Children were randomized to 2 groups to receive either play dough (group PD) (n=52) or not (group C) (n=52) before administration of oral premedication.
Measurements:
Children's premedication anxiety was determined by the modified Yale Preoperative Anxiety Scale (mYPAS).
Main Results:
The difference in mYPAS scores between groups at T0 (immediately after entering the preoperative holding area) was not significant (P=.876). Compared with group C, group PD was associated with lower mYPAS scores at T1 and T2 (P<.001). In group PD, mYPAS scores were significantly lower at both T1 and T2 as compared with the scores at T0 (P<.001); they were similar between T1 and T2 (P>.001).
Conclusion:
This study showed that distraction in the form of playing with play dough facilitated administration of oral midazolam in young children.
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