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Single-Blinded Randomized Controlled Study on Use of Interactive Distraction Versus Oral Midazolam to Reduce

Barbara Stewart, Mary A Cazzell, Terri Pearcy

    Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses
    |November 11, 2018
    PubMed

    Insights

    Tablet-based interactive distraction (TBID) significantly reduced preoperative anxiety and emergence delirium in children undergoing surgery compared to midazolam. This intervention also shortened postanesthesia length of stay, offering a more effective approach.

    Area of Science:

    • Pediatric Anesthesiology
    • Child Psychology
    • Medical Technology

    Background:

    • Preoperative anxiety and emergence delirium are common in pediatric patients undergoing surgery.
    • Current pharmacological interventions like midazolam have limitations.
    • Novel non-pharmacological approaches are needed to manage perioperative distress in children.

    Purpose of the Study:

    • To compare the efficacy of tablet-based interactive distraction (TBID) versus oral midazolam in mitigating preoperative anxiety, emergence delirium, and postanesthesia length of stay.
    • To evaluate the impact of TBID on children aged 4 to 12 years undergoing outpatient surgery.

    Main Methods:

    • A single-blinded, prospective randomized controlled trial was conducted with 102 children and their caregivers.
    • Participants were assigned to either TBID (1 minute preseparation) or oral midazolam (15-45 minutes preseparation).
    • Outcome measures included anxiety and delirium scores, caregiver ratings, and postanesthesia discharge times.

    Main Results:

    • The TBID group exhibited significantly lower anxiety during separation and mask induction (P < .001).
    • TBID also led to reduced emergence delirium (P = .001), earlier extubation (P = .007), and faster discharge (P = .0001).

    Conclusions:

    • Tablet-based interactive distraction is more effective than oral midazolam for managing preoperative anxiety and emergence delirium in pediatric surgical patients.
    • TBID offers a beneficial alternative, improving patient outcomes and reducing postanesthesia length of stay.
    Abstract

    Keywords:
    interactive distractionoral midazolampostanesthesia emergence deliriumpreoperative anxiety

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