Effect of video-based interventions on emergence delirium in pediatric patients: a systematic review and
Yue Wang1, Lifang Wang1, Nan Liang1
1China-Japan Friendship Hospital, Department of Anesthesiology, Beijing, China.
Insights
Video interventions may reduce pediatric emergence delirium, especially in children under seven. While not statistically significant overall, these methods show promise for managing emergence delirium and anxiety in pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Medical Technology
Background:
- Emergence delirium is common in children post-anesthesia.
- Video-based interventions (cartoons, games, VR) are emerging as potential solutions.
- Evidence for their effectiveness in reducing pediatric emergence delirium is needed.
Purpose of the Study:
- To systematically review randomized controlled trials on video interventions for pediatric emergence delirium.
- To evaluate the efficacy of video-based methods in reducing emergence delirium and preoperative anxiety.
- To identify specific age groups that benefit most from these interventions.
Main Methods:
- Systematic literature search across Embase, MEDLINE, and Cochrane Library.
- Inclusion of eight randomized controlled trials with 872 pediatric patients.
- Data analysis using Review Manager 5.4 for effectiveness evaluation.
Main Results:
- A trend towards lower Pediatric Anesthesia Emergence Delirium scores (p=0.10) and incidence (p=0.52) was observed.
- Significant reduction in preoperative anxiety scores (p<0.00001) was noted in seven studies.
- Subgroup analysis showed significant reduction in delirium scores for children under seven (p=0.001).
Conclusions:
- Video interventions show potential for reducing pediatric emergence delirium and anxiety.
- Statistical significance was not reached in the overall sample, but was significant in children under seven.
- Further research is warranted to confirm efficacy across broader pediatric populations.
Objective:
Emergence delirium is frequently observed in pediatric patients. With advancements in video-based interventions, such as cartoons, video games, and virtual reality, these modalities may contribute to a reduced incidence of emergency delirium among children. However, robust evidence supporting their efficacy remains necessary.
Methods:
The authors conducted a systematic search across multiple databases, including Embase, MEDLINE, and Cochrane Library, to identify all randomized controlled trials comparing video-based interventions with control treatments in pediatric emergence delirium. Data were aggregated and analyzed using Review Manager 5.4 to evaluate the effectiveness of video-based interventions.
Results:
The analysis included eight randomized controlled trials comprising 872 children. The intervention group showed a trend toward lower Pediatric Anesthesia Emergence Delirium scores (p = 0.10) and fewer emergence delirium events (p = 0.52). Seven studies demonstrated that video-based interventions significantly reduced preoperative anxiety, as indicated by decreased scores on the modified Yale Pre-operative Anxiety Scale (p < 0.00001). Anesthesia duration did not significantly differ between the intervention and control groups (p = 0.16). Notably, subgroup analyses revealed a significant reduction in Pediatric Anesthesia Emergence Delirium scores among children under seven years of age (p = 0.001).
Conclusions:
Video-based interventions were linked to lower Pediatric Anesthesia Emergence Delirium scores and a decreased incidence of emergence delirium events. However, these results did not reach statistical significance across the broader sample. Notably, in children under seven, these interventions significantly reduced the scores.
Level Of Evidence:
III.
