Single-Blinded Randomized Controlled Study on Use of Interactive Distraction Versus Oral Midazolam to Reduce Pediatric Preoperative Anxiety, Emergence Delirium, and Postanesthesia Length of Stay

Stewart, Barbara; Cazzell, Mary; Pearcy, Terri

doi:10.1016/j.jopan.2018.08.004

Cited by 32 publications

(36 citation statements)

References 12 publications

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“…Prevention of anxiety, both from the patient and caregivers' perspective, was the most common primary outcome of interest, accounting for over a fifth of studies (n=20, 23%). 32,37,38,49,53,54,57,58,59,63,70,71,79,81,91,93,94,103,105,108 Prevention of anxiety was a secondary outcome of interest in a further nine (10%) studies. 22,23,25,47,50,55,69,73,80 Of the studies including anxiety prevention as the primary outcome, nine studies (47%) were focused on adult patients; 32,38,53,57,59,71,81,94,105 nine were focused on pediatric patients, 37,49,54,63,79,91,93,103,108 (with four of these also including caregivers as a sub-population, …”

Section: Prevention Of Caregiver and Patient Anxietymentioning

confidence: 99%

“…Predominantly, studies were focused on the adult population (n= 71, 83%), with 10 studies focusing on pediatrics as the population of interest (12%). Four studies included both caregivers and children as the population of interest, 23,47,49,54 whilst one study focused on caregivers only. 107 Two studies focused on adolescents, 22,37 and one study included both adults and children.…”

Section: Perioperative Research Populations and Phases Of Care Addresmentioning

confidence: 99%

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<p>Nurse-Led Randomized Controlled Trials in the Perioperative Setting: A Scoping Review</p>

Munday¹,

Higgins²,

Mathew³

et al. 2020

JMDH

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Purpose: Nurses provide care at each phase of the complex, perioperative pathway and are well placed to identify areas of care requiring investigation in randomized controlled trials. Yet, currently, the scope of nurse-led randomized controlled trials conducted within the perioperative setting are unknown. This scoping review aims to identify areas of perioperative care in which nurse-led randomized controlled trials have been conducted, to identify issues impacting upon the quality of these trials and identify gaps for future investigation. Methods: This scoping review was conducted in reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Searches were conducted in PubMed, Embase, Cumulative Index for Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trials, with a date range of 2014-19. Sources of unpublished literature included Open Grey, and ProQuest Dissertation and Theses, Clinical Trials.gov and the Australian and New Zealand Clinical Trials Registry. After title and abstract checking, full-text retrieval and data extraction, studies were appraised using the Joanna Briggs Institute Critical Appraisal Checklists for randomized controlled trials. Data were synthesized according to the main objectives. Key information was tabulated. Results: From the 86 included studies, key areas where nurses have led randomized controlled trials include patient or caregiver anxiety; postoperative pain relief; surgical site infection prevention: patient and caregiver knowledge; perioperative hypothermia prevention; postoperative nausea and vomiting; in addition to other diverse outcomes. Issues impacting upon quality (including poorly reported randomization), and gaps for future investigation (including a focus on vulnerable populations), are evident. Conclusion: Nurse-led randomized controlled trials in the perioperative setting have focused on key areas of perioperative care. Yet, opportunities exist for nurses to lead experimental research in other perioperative priority areas and within different populations that have been neglected, such as in the population of older adults undergoing surgery.

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Section: Prevention Of Caregiver and Patient Anxietymentioning

confidence: 99%

Section: Perioperative Research Populations and Phases Of Care Addresmentioning

confidence: 99%

<p>Nurse-Led Randomized Controlled Trials in the Perioperative Setting: A Scoping Review</p>

Munday¹,

Higgins²,

Mathew³

et al. 2020

JMDH

View full text Add to dashboard Cite

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“…The use of audiovisual information tools has also been shown to alleviate preoperative anxiety in children [31,32]. In another randomized trial, distraction by using an interactive tablet was more effective than midazolam sedation in alleviating anxiety at induction, decreasing emergence delirium, and allowing earlier extubation, and earlier hospital discharge [13]. Conversely, in children aged 9 to 18 years scheduled for thoracic surgery, all of whom received preoperative information by a nurse, adding information by a psychologist was effective only in those children with a low level of trait anxiety [33].…”

Section: Discussionmentioning

confidence: 99%

Electric Toy Car to Reduce Anxiety Before a Cardiac Catherization: Randomized Controlled Trial

Chambon¹,

Fournier²,

Tagorti³

et al. 2021

Preprint

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Anxiety before an invasive intervention is associated in children with persistent psychological disorders. We studied the effect of the transfer to the catheterization room by an electric toy-car on the anxiety of children and their parents before a cardiac catheterization. Forty-eight children with a median age of 5.6 years [4.2-7.0] were randomized to either riding on an electric car to go to the catheterization laboratory or being transported lying supine on a gurney. Anxiety assessments were performed by a physician blinded to allocation group on the day before the procedure (T0) and at anesthesia induction (T1). The modified Yale score (mYPAS-SF) and visual analog scale for anxiety (VAS-A) were used in the children, and the VAS-A in the parents. The mYPAS-SF, VAS-A-child and the VAS-A-parent scores were significantly higher at T1 than at T0 (P < 0.001, P < 0.001, and P = 0.005, respectively). The primary outcome (the median mYPAS-SF score at T1) was not significantly different in the two groups when males and females were combined. At T1, the VAS-A-child score, however, was significantly lower in the intervention than the control group (22 versus 55, P < 0.001). In the boys, the median mYPAS-SF score at T1 was significantly lower in the intervention group (25.0 versus 51.0, P = 0.024). No difference was observed in girls. The VAS-A parent score was lower at T1 in the intervention group (60 versus 87, P = 0.05). Conclusion: Riding to the catheterization laboratory on an electric toy car decreased anxiety at anesthesia induction in boys and also decreased parental anxiety.Clinical trial Registration: Registration number: ID-RCB: 2019-A00459-48. Date of registration: March 27th 2019.

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“…A review of studies using video for distraction published between 2005 and 2017 showed a reduction in preoperative anxiety but little evidence of ED reduction [57]. However, a study published in 2019 [58] compared the effect of oral midazolam premedication with the effect of tablet-based interactive distraction (TBID). The PAED scale was used to assess ED.…”

Section: Interactive Distractionmentioning

confidence: 99%

Postoperative emergence delirium in children: a narrative review of recent publications

Grotmol

Nesarajah

Hansen

2021

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Background: Emergence delirium is a challenge in pediatric anesthesiology, with important unanswered questions concerning incidence, causation, diagnosis, treatment, and sequelae. In this review, we will present the recent research with a particular focus placed on treatment and prevention options. Methods: A wide literature search was conducted across MEDLINE and other databases using PubMed, Embase, Ovid, and the Cochrane Library (latest access: 23 November 2020). The collected publications were assessed for relevance. Only randomized controlled trials and observational studies on postoperative emergence delirium in children were included. Exclusion criteria were articles published before 2018, and studies comprising children older than 12 years of age, mental retardation, or chronic diseases. Results: The final number of studies included in this review was 44. Risk factors identified for emergence delirium were volatile inhalation anesthetics, young age, child temperament, preoperative anxiety, male gender, and specific surgical procedures. Preventive and/or intervention measures were pharmacological (e.g. TIVA, α2-adrenergic agonists (particularly dexmedetomidine), ketamine, propofol, midazolam, opioids (fentanyl)) and non-pharmacological measures (e.g. video or tablet distraction, familiarization with the operating environment, use of mother’s voice, visual preconditioning in eye surgery). Conclusion: ED should be considered a “vital sign” and recorded and documented in all children in the PACU. There is an urgent need for future research to fill in missing gaps of knowledge regarding ED. Implementation of a standardized and validated screening tool for ED are high priorities as is the impact of perioperative monitoring of children at risk to prevent ED.

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Single-Blinded Randomized Controlled Study on Use of Interactive Distraction Versus Oral Midazolam to Reduce Pediatric Preoperative Anxiety, Emergence Delirium, and Postanesthesia Length of Stay

Cited by 32 publications

References 12 publications

<p>Nurse-Led Randomized Controlled Trials in the Perioperative Setting: A Scoping Review</p>

<p>Nurse-Led Randomized Controlled Trials in the Perioperative Setting: A Scoping Review</p>

Electric Toy Car to Reduce Anxiety Before a Cardiac Catherization: Randomized Controlled Trial

Postoperative emergence delirium in children: a narrative review of recent publications

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