Systematic Review: Audiovisual Interventions for Reducing Preoperative Anxiety in Children Undergoing Elective Surgery

J Pediatr Psychol. 2016 Mar;41(2):182-203. doi: 10.1093/jpepsy/jsv094. Epub 2015 Oct 17.


Objective: To examine the effectiveness of Audiovisual (AV) interventions at reducing preoperative anxiety and its associated outcomes in children undergoing elective surgery.

Methods: A systematic review of randomized controlled trials (RCTs) and nonrandomized studies where the primary outcome was children's preoperative anxiety was conducted. Secondary outcomes included postoperative pain, behavioral changes, recovery, induction compliance, satisfaction, and cost-effectiveness. The risk of bias of each study was assessed.

Results: In all, 18 studies were identified. A meta-analytic approach and narrative synthesis of findings were used to summarize the results of the studies.

Conclusions: This systematic review suggests that AV interventions can be effective in reducing children's preoperative anxiety. Videos, multi-faceted programs, and interactive games appear to be most effective, whereas music therapy and Internet programs are less effective. While AV interventions appear potentially useful, adequately powered RCTs are required to conclusively pinpoint the components and mechanisms of the most effective AV interventions and guide practice.

Keywords: anxiety; children; educational interventions; meta-analysis; randomized controlled trial; systematic review.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Anxiety / prevention & control*
  • Anxiety / psychology*
  • Attention
  • Audiovisual Aids*
  • Child
  • Child, Preschool
  • Elective Surgical Procedures / psychology*
  • Female
  • Humans
  • Internet
  • Male
  • Music Therapy
  • Play and Playthings
  • Preoperative Care / methods*
  • Preoperative Care / psychology*
  • Preoperative Period*
  • Randomized Controlled Trials as Topic