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

Liu, P.P.; Sun, Yifeng; Wu, Changying; Xu, Wenyin; Zhang, R.D.; Zheng, Jijian; Huang, Yali; Chen, Yu-e; Zhang, M.Z.; Wu, Jun-Zheng

doi:10.1016/j.bja.2018.02.067

Cited by 36 publications

(49 citation statements)

References 34 publications

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“…A recent randomized controlled study demonstrated that riding in a toy car significantly reduced preoperative anxiety compared with riding on a stretcher among children with or without premedication, which was consistent with our results [12]. Interestingly, the anxiolytic effect of riding in a toy car was similar to that of oral midazolam, even just before anesthesia induction in the previous study [12]. These favorable results may have been due to the age range of the study population (2-5 years), which corresponds to the younger children in the present study.…”

Section: Discussionsupporting

confidence: 92%

“…Until recently, however, this simple method has not been evaluated through clinical trials. Only a very recent study by Liu et al [12] compared the anxiolytic effect of transport in a children's toy car to that in a conventional transport vehicle, and favorable results were obtained in children aged 2-5 years. However, there is still limited evidence to support the effect of the transport method on reducing preoperative anxiety among children, and furthermore, it is not clear whether this anxiolytic effect varies according to the age of the children.…”

Section: Introductionmentioning

confidence: 99%

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Effect of transportation method on preoperative anxiety in children: a randomized controlled trial

Park

Lee

et al. 2020

Korean J Anesthesiol

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Background:This study was performed to evaluate the effect of a wagon as a transport vehicle instead of the standard stretcher car to reduce children's anxiety of separation from parents. The secondary goal was to evaluate whether this anxiolytic effect was related to age. Methods: We divided 80 children (age 2-7 years) into two groups. The stretcher group was transferred to the operating room on a conventional stretcher car, whereas the wagon group was transferred using a wagon. The level of anxiety was evaluated three times using the Modified Yale Preoperative Anxiety Scale (mYPAS): in the waiting area (T0), in the hallway to the operating room (T1), and before induction of anesthesia (T2). Results: The mYPAS score was significantly lower in the wagon group (36.7 [31.7, 51.7]) than in the stretcher group (51.7 [36.7, 83.3]) at T1 (P = 0.007). However, there was no difference in the mYPAS score between the two groups at T2 (46.7 [32.5, 54.2] vs. 51.7 [36.7, 75.0], respectively, P = 0.057). The baseline anxiety tended to be lower with increasing age (r = −0.248, P = 0.031). During transportation to the operating room, the increase in the mYPAS score (T1-T0) was greater as the age of children decreased in the stretcher group (r = −0.340, P = 0.034). However, no correlation was observed in the wagon group (r = −0.053, P = 0.756). Conclusions:The wagon method decreased preoperative anxiety, suggesting that it may be a good alternative for reducing preoperative anxiety in children.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Effect of transportation method on preoperative anxiety in children: a randomized controlled trial

Park

Lee

et al. 2020

Korean J Anesthesiol

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“…A randomized controlled trial from China that used the same assessment tools as we did enrolled children aged 2 to 5 years undergoing their rst corrective surgery for congenital heart disease [15]. The children in the intervention group were taken to the operating room in a manual toy car pushed by an orderly, instead of being transported supine on a gurney.…”

Section: Discussionmentioning

confidence: 99%

“…Distraction with a hand-held video game or electronic tablet decreased preoperative anxiety to a greater extent than did midazolam [13,14]. The toy-car is a recent tool whose impact on child anxiety has been little studied [15]. This playful tool involves the child through play, like the other distracting tools currently available, but also makes the child an actor of his own care.…”

Section: Introductionmentioning

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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“…18 Additionally, research on nonpharmacologic preoperative anxiolytic techniques (eg, transporting patient in a toy car, video distraction), has shown promising results. [19][20] While midazolam administration can improve pediatric anxiety preoperatively, other adjunctive anxiolytic techniques can also be useful in this setting. 21,22 The incidence of use of midazolam as a premedication cannot be clearly ascertained.…”

Section: Discussionmentioning

confidence: 99%

How Pediatric Anesthesiologists Manage Children with OSA Undergoing Tonsillectomy

Roberts

Sayegh

Ellison

et al. 2019

Ann Otol Rhinol Laryngol

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Objective: The purpose of this study was to describe typical anesthesia practices for children with obstructive sleep apnea (OSA). Study Design: Online survey. Method: A sample of pediatric anesthesiologists received the survey by email. Results: 110 respondents were included. 46.4% worked in a free-standing children’s hospital and 32.7% worked in a children’s facility within a general hospital. 73.6% taught residents. 44.4% saw at least one child with OSA per week, 25.5% saw them daily. On a 100-mm visual analog scale, respondents rated their comfort with managing these children as 84.94 (SD 17.59). For children with severe OSA, 53.6% gave oral midazolam preoperatively, but 24.5% typically withheld premedication and had the parent present for induction. 68.2% would typically use nitrous oxide for inhalational induction. 68.2% used fentanyl intraoperatively, while 20.0% used morphine. 61.5% reduced their intraop narcotic dose for children with OSA. 98.2% used intraoperative dexamethasone, 58.2% used 0.5 mg/kg for the dose. 98.2% used ondansetron, 62.7% used IV acetaminophen, and 8.2% used IV NSAIDs. 83.6% extubated awake. 27.3% of respondents stated that their institution had standardized guidelines for perioperative management of children with OSA undergoing adenotonsillectomy. People who worked in children’s hospitals, who had >10 years of experience, or who saw children with OSA frequently were significantly more comfortable dealing with children with OSA ( P < 0.05). Conclusion: Apart from using intraoperative dexamethasone and ondansetron, management varied. These children would likely benefit from best practices perioperative management guidelines.

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

Abstract: ChiCTR-IOR-17012791.

Cited by 36 publications

References 34 publications

Effect of transportation method on preoperative anxiety in children: a randomized controlled trial

Effect of transportation method on preoperative anxiety in children: a randomized controlled trial

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

How Pediatric Anesthesiologists Manage Children with OSA Undergoing Tonsillectomy

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