Related Experiment Video
Updated: Sep 28, 2025
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
The effect of using tablet computer on surgical stress: A single-blinded randomized controlled trial
Kubra Evren Sahin1, Aytac Karkiner2
1Department of Anesthesiology and Reanimation, University of Health Sciences, Dr. Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey.
Insights
Tablet computers effectively reduce preoperative anxiety in pediatric surgical patients, improving comfort during separation and mask application. This method offers a valuable alternative to midazolam for managing anxiety in children.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Child Psychology
Background:
- Preoperative anxiety is common in pediatric surgical patients.
- Anxiety can negatively impact patient experience and recovery.
- Effective anxiety management strategies are crucial for pediatric care.
Purpose of the Study:
- To evaluate the effects of tablet computer use on preoperative anxiety in children undergoing elective surgery.
- To compare the efficacy of tablet computers versus midazolam in reducing anxiety.
- To assess the impact on separation anxiety and mask acceptance.
Main Methods:
- Prospective, single-blinded, randomized controlled trial involving 300 pediatric patients (ages 4-10).
- Patients were randomized into Midazolam, Tablet Computer, or Control groups.
- Anxiety assessed using modified-Yale Preoperative Anxiety Scale (mYPAS), Parental Separation Anxiety Scale (PSAS), and Mask Acceptance Scale (MAS).
Main Results:
- Tablet use significantly reduced anxiety scores compared to control (p < 0.001).
- Midazolam showed the greatest ease of separation and mask acceptance.
- Tablet computers were more effective than control in improving comfort and reducing anxiety.
- Post-hospitalization behavior scores were significantly higher in the control group.
Conclusions:
- Tablet-based games are effective in improving pediatric patients' comfort preoperatively.
- Both midazolam and tablet computers reduce anxiety, with midazolam offering slightly better outcomes for separation and mask acceptance.
- Tablet computers provide a viable, non-pharmacological option for managing preoperative anxiety in children.
Introduction:
The purpose of our study was to evaluate the effects of tablet computer method on children with and without anxiety. The study was designed as a prospective single-blinded randomized controlled trial.
Materials And Methods:
The population of the study were 300 patients between the ages of 4 and 10 years old who were scheduled for their first elective surgery for phimosis-inguinal hernia-hydrocele-undescended testis-hypospadias. The initial anxiety scores of the patients were evaluated using modified-Yale Preoperative Anxiety Scale (mYPAS). Group-Midazolam, Group-Tablet, Group-Control were formed by applying randomization to the patients. The anxiety levels of the patients were evaluated in the waiting room using mYPAS after 0.5 mg/kg midazolam or tablet computer. Patient anxiety about separation from their families was evaluated with Parental Separation Anxiety Scale (PSAS), and reactions to the anaesthesia mask were evaluated with Mask Acceptance Scale (MAS). Also, the time spent by the patients in the Post-Operative Care Unit (PACU) was evaluated. Post-Hospitalization Behavior Questionnaire (PHBQ) scores of the patients were determined by the anesthesiologist one week after the surgery.
Results:
The study compared the anxiety levels in groups. There were significant differences in the post-anxiolytic-mYPAS-scores and percentages of decrease from the preoperative baseline measurements (p < 0.001 and p < 0.001). There were significantly more children who were easily separated from their parents (PSAS-Score 1) in Group-Midazolam (p < 0.01). The children in Group-Midazolam also accepted the masks more readily (MAS-Score 1) than other (p < 0.001). Differences in the duration of the recovery time and mean PHBQ-scores between the groups were also significant (p < 0.001 for each). For children with anxiety, the recovery time for those in Group-Midazolam was significantly longer than other. For children without anxiety (p < 0.001), the duration of the recovery time in Group-Midazolam was also found to be significantly longer than other. The PHBQ-scores of the children in Group-Control with anxiety and without anxiety were significantly higher than other (p < 0.05 for each). Also, there were significant differences in the distribution of the PSAS-scores between the children with and without anxiety. Anxiety had no impact on the distribution of the MAS-scores (p = 0.045 and p = 0.100).
Conclusion:
Playing tablet-based games in the preoperative period enabled pediatric patients to be more comfortable while waiting in their rooms, leaving their families, and applying an anaesthetic mask. In pediatric patient with and without anxiety, midazolam separation from the family and accepting the anesthesia mask is easiest in midazolam, second in those who are given a tablet computer.
