The effectiveness of transport in a toy car for reducing preoperative anxiety in preschool children: a randomised controlled prospective trial

Br J Anaesth. 2018 Aug;121(2):438-444. doi: 10.1016/j.bja.2018.02.067. Epub 2018 May 4.

Abstract

Background: This study was designed to determine whether transport of a paediatric inpatient in a children's ride-on toy car has an effect on perioperative levels of anxiety compared with transport on a hospital gurney with or without oral midazolam premedication.

Methods: In this prospective study, 108 children aged 2-5 yr with congenital heart disease and undergoing first surgical correction were randomly allocated to one of three groups: Group C (transport in a children's ride-on car), Group G (transport on a gurney without premedication), or Group M (transport on a gurney and received premedication of oral midazolam 0.5 mg kg-1). The modified Yale Preoperative Anxiety Scale-Short Form and parent-recorded anxiety VAS were applied to evaluate anxiety in the following time points: pre-anaesthesia visit (the day before surgery), upon getting in the ride-on car or on the gurney in the ward, upon arriving in the preoperative holding area, at the moment of leaving from the holding area to the operating room (OR) (coincided with separation from parents), at the time after entering the OR, and at the time just before anaesthesia induction.

Results: Children in Group C exhibited significantly lower levels of anxiety from the time they got into the ride-on car until the time they entered the OR, compared with the other two groups (P<0.001). The subjects in Group C had similarly low anxiety levels to those in the Group M at the time before induction (P=0.914).

Conclusions: Transport in a ride-on toy car can relieve preoperative anxiety in preschool children undergoing surgery to a comparable degree as midazolam.

Clinical trial registration: ChiCTR-IOR-17012791.

Keywords: anxiety; child; hospitalised; preoperative period; preschool.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthesia, General
  • Anxiety / prevention & control*
  • Cardiac Surgical Procedures / methods
  • Child, Preschool
  • Female
  • Heart Defects, Congenital / surgery
  • Humans
  • Hypnotics and Sedatives
  • Intubation, Intratracheal
  • Male
  • Midazolam
  • Neuropsychological Tests
  • Parents / psychology
  • Play and Playthings*
  • Preanesthetic Medication
  • Preoperative Care / methods*
  • Prospective Studies

Substances

  • Hypnotics and Sedatives
  • Midazolam