Background & Objectives: Mobile interactive tools are effective to reduce children anxiety at parental separation in the operative theatre (1-2). Our aim was to compare the effects of midazolam in premedication with age-appropriate game apps (iPad tablet) on children aged 4-10 yr during and after ambulatory surgery. Anxiety was assessed both in children and in parents.
Materials & Methods: The study protocol was approved by The Institutional Research Committee. Children were randomly allocated to one of the two groups (MDZ or TAB tablet) using computer generated list. Patients in group MDZ received midazolam 0,3mg/kg per os (PO) or per rectum (PR) or were given an electronic tablet (iPAD) 20 min before anesthesia. Parental (using STAI score) and children anxiety (using m-YPAS scale) were measured by 2 independent psychologists: 1) at arrival at hospital 2) at separation from the parents 3) during induction. Anesthetic nurse ranked from 0 (not satisfied) to 10 (highly satisfied) the quality of induction of anesthesia (EVA tech). Thirty min after the last dose of nalbuphine or 45 min after arrival in PACU, the children were transferred in the ambulatory surgery ward where parental anxiety (STAI 3) and children anxiety (m-YPAS 4) were evaluated. In addition, parent’s satisfaction with anesthesia procedure was rated from 0 to 10 (EVA Par). Postoperative behavior changes were assessed with the Post Hospital Behavior Questionnaire (PHBQ). When appropriate, we used Chi 2 test, Student’s t test, the test of Wilcoxon for variables and a mixed model for repeated measure for the scores.
Results: 54 patients were included in the MDZ group and 58 in the TAB group. The m-YPAS score was not evolving over the 4 periods of time differently between groups. The level of STAI as well as its evolution over the 3 periods of measure was not different between the 2 groups. Both parents and nurses found anesthesia more satisfying in the TAB group.
Conclusion: Our study showed that children and parental anxiety are equally blunt by MDZ or TAB. However, the quality of induction of anesthesia as well parental satisfaction were juged better in group TAB. TAB is a non pharmacologic tool which can reduces perioperative stress without any sedative effect in pediatric ambulatory surgery.
1. Patel Anuradha P. Pediatric Anesthesia 2006; 16: 1019-1027
2. Seiden SC et al.Paediatr Anaesth. 2014;24:1217-23
Disclosure of Interest: None declared