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A Retrospective Review of a Bed-mounted Projection System for Managing Pediatric Preoperative Anxiety

Thomas J Caruso1, Jeremy H Tsui1, Ellen Wang1

  • 1Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, Calif.

Pediatric Quality & Safety
|September 20, 2018
PubMed

Insights

The bedside entertainment and relaxation theater (BERT) was less effective than midazolam for pediatric anesthesia induction cooperation but reduced preinduction time and increased playful emotions. Further research is needed to optimize BERT for pediatric anxiety management.

Area of Science:

  • Pediatric Anesthesiology
  • Patient Experience
  • Anxiety Management

Background:

  • Preoperative anxiety is common in children undergoing anesthesia.
  • Midazolam is a standard pharmacological approach.
  • The bedside entertainment and relaxation theater (BERT) was developed as a non-pharmacological alternative.

Purpose of the Study:

  • To compare the efficacy of BERT versus midazolam in achieving patient cooperation during anesthesia induction.
  • To assess patient emotions and the timeliness of BERT utilization.

Main Methods:

  • Retrospective cohort study of pediatric patients (N=313) undergoing anesthesia.
  • Comparison of induction cooperation using logistic regression.
  • Analysis of patient emotion and preoperative time using multinomial logistic and ordinary least squares regression.

Main Results:

  • While 93% of patients were cooperative, the midazolam group showed higher cooperation rates (P=0.04).
  • The BERT group exhibited more "playful" emotions compared to "sedated" (P<0.001).
  • BERT significantly reduced preoperative readiness time by 14.7 minutes (P=0.001).

Conclusions:

  • Midazolam was more effective for induction cooperation than BERT.
  • BERT offers a significant reduction in preinduction time.
  • BERT may positively influence patient emotional state, promoting a "playful" disposition.
Abstract

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