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Anxiety Reaction in Children During Cast Removal using Oscillating Saw versus Cast Shear - A Randomised, Prospective
N A Mohamed-Zain1, K Jamil1, R Penafort2
1Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Insights
The oscillating saw, producing over 80 dB of noise, significantly increased children's anxiety during cast removal compared to cast shears. Cast shears are recommended for anxious children due to lower fear levels.
Area of Science:
- Pediatric Orthopedics
- Pain and Anxiety Management
Background:
- Pediatric cast removal can induce anxiety.
- Comparing patient anxiety levels between different cast removal methods is crucial for improving patient experience.
Purpose of the Study:
- To compare anxiety levels in children during cast removal using an oscillating saw versus cast shears.
- To evaluate the impact of noise and fear on pediatric patients during orthopedic procedures.
Main Methods:
- A randomized prospective study involved 102 children undergoing cast removal.
- Anxiety was measured via heart rate monitoring and the Children's Fear Scale (CFS).
- Participants were divided into groups using either an oscillating saw or cast shears.
Main Results:
- The oscillating saw group exhibited significantly higher heart rates during cast removal (p<0.05).
- The oscillating saw generated noise levels exceeding 80 dB (mean 103.3 dB).
- Children in the cast shear group reported significantly lower fear levels (p<0.05).
Conclusions:
- High noise levels from oscillating saws are linked to increased anxiety in pediatric patients.
- Cast shears offer a less anxiety-provoking, simple, and cost-effective alternative for cast removal, especially in anxious children.
Introduction:
To compare the anxiety levels demonstrated by children during cast removal procedure between oscillating saw vs cast shear methods.
Material And Methods:
A randomised prospective study of 102 children (mean age 8.3 ± 3.5 years) with fractures involving upper or lower limbs. Children undergoing removal of cast were divided into 2 groups; either by an oscillating saw or a cast cutting shear. The level of anxiety was assessed by recording the heart rate with a portable fingertip pulse oximeter before, during and after removal of the cast. Objective assessment was performed by documenting the fear level on Children's Fear Scale (CFS).
Results:
There was a significant increase in the heart rate of children during cast removal while using the oscillating saw compared to cast shear (p<0.05). The noise level produced by the saw exceeded 80 dB (mean 103.3 dB). The fear level was significantly lower in the cast shear group (p<0.05).
Conclusion:
The noise produced by the oscillating saw was associated with an increased anxiety level in children undergoing cast removal. Cast shear is a simple and inexpensive instrument that can be used for cast removal in overly anxious children.
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