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Effects of virtual tour on perioperative pediatric anxiety
Teresa Franco Castanys1, Anabel Jiménez Carrión1, Frederic Ródenas Gómez1
1Department of Anesthesiology, Perioperative Care and Pain Medicine. Division of Pediatric Anesthesia, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
Insights
Virtual tours significantly reduced preoperative anxiety in children undergoing surgery, improving satisfaction and anesthetic induction. However, no impact was observed on longer-term outcomes.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Medical Technology Integration
Background:
- Pediatric perioperative anxiety is common, leading to adverse effects like delirium and behavioral issues.
- Standard preparation may not sufficiently mitigate preoperative anxiety in children.
- Exploring innovative interventions is crucial to improve pediatric surgical experiences.
Purpose of the Study:
- To compare preoperative anxiety levels in children using virtual operating room tours versus standard preparation alone.
- To evaluate the impact of virtual tours on anesthetic induction cooperation and parental satisfaction.
- To assess the effect of virtual tours on postoperative delirium and behavioral changes.
Main Methods:
- Prospective, randomized, controlled, blinded trial (NCT04043663) involving 125 healthy children (4-12 years).
- Intervention: Standard preparation plus a virtual tour of the operating room (VT+) vs. standard preparation alone (VT-).
- Assessed anxiety (Yale Preoperative Anxiety Scale), induction compliance, parental anxiety, postoperative delirium, behavioral changes, and satisfaction.
Main Results:
- The Virtual Tour Group (VT+) showed a statistically significant reduction in preoperative anxiety compared to the Non-virtual Tour Group (VT-) (p=0.0086).
- Anesthetic induction compliance was significantly improved in the VT+ group (p=0.018 for perfect, p=0.0428 for moderate).
- Parental satisfaction was significantly higher in the VT+ group for specific aspects of the preparation (p=0.0213, p<0.0001, p=0.0130).
Conclusions:
- Virtual tours are effective in reducing preoperative anxiety and enhancing satisfaction in pediatric surgical patients.
- The intervention facilitates smoother anesthetic induction in children.
- No significant impact was found on longer-term outcomes such as postoperative delirium or behavioral changes.
Background:
There is a high incidence of perioperative anxiety in the pediatric population, with adverse side effects, such as emergency delirium and maladaptive postoperative behaviors.
Aims:
The study's objective was to compare the level of preoperative anxiety in children after standard preparation plus a virtual tour of the operating room vs. standard preparation alone.
Patients/Methods:
This was a prospective single-center, randomized, controlled, blinded trial with parallel assignment, registered as NCT04043663. Eligible subjects were healthy children (ASA I-II) aged 4-12, scheduled for outpatient surgery. Five visits were conducted during the study, two at the hospital and three over the phone. Variables assessed were child's anxiety through the modified Yale Perioperative Anxiety Scale, demographic data, cooperation with induction through the Induction Compliance Checklist, preoperative parental anxiety through the State-Trait Anxiety Inventory and Anxiety Visual Analog Scale, the postoperative delirium degree through the Pediatric Anesthesia Emergence Delirium Scale, the presence of behavioral changes through the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery, and the overall parental satisfaction.
Results:
A total of 125 participants were included; 61 (48.8%) of them were randomized to the Virtual Tour Group (VT+) and 64 (51.2%) to the Non-virtual Tour Group (VT-). Yale Preoperative Anxiety Scale results in VT+ vs. VT- were mean 27.26 vs. 32.57, and median 23.4 (CI 95% 23.4-23.4) vs. 23.4 (CI 95% 23.4-33.4), (p = .0086). In the VT+ group, satisfaction was higher for questions one (p = .0213), three (p = <.0001), and four (p = .0130). Throughout the study, we observed a significant reduction in perioperative anxiety in the VT+ group, facilitating anesthetic induction in perfect (p = .018) and moderate compliance (p = .0428). The other variables did not show statistically significant differences.
Conclusion:
Our study confirms previous studies that found virtual tours for perioperative patients may reduce perioperative anxiety and improve satisfaction. We found no impact on longer-term outcomes.
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