Does Distraction With a Hand Held Video Game Reduce Preoperative and Emergence Anxiety in Children?

Preoperative anxiety is characterized by subjective feelings of tension, apprehension, nervousness and worry. In children, preoperative anxiety is reported to result in postoperative negative psychological effects, including nightmares, eating problems and increased fear of doctors. Previous studies have assessed anxiety in children during the preoperative period and the effects of premedication and parental presence. Midazolzam has been shown to reduce preoperative anxiety in children but post operative recovery maybe delayed for children undergoing a short operative procedure. Distraction may be particularly helpful in children ages 6-12 as these children are curious about their environment. An association between preoperative anxiety and emergence agitation has been suggested. Emergence agitation in children is not well understood but is a frightening experience for child and parent. A previous study demonstrated the efficacy of hand held video games used as an interactive distraction to allay preoperative anxiety. The purpose of this study is to treat preop anxiety with premedication, or video game and to evaluate the impact of these interventions on the incidence and severity of emergence agitation.

• Drug: Midazolam
  Midazolam 0.5mg/kg
• Device: Game Boy
  Children given video game as a distraction in preop holding and were permitted to continue playing the game in OR during induction
  Other Name: Nintendo-DS Game Boy

• Active Comparator: 2. Video Game
  Intervention: Device: Game Boy
• Active Comparator: 1. Midazolam 0.5mg/kg
  Intervention: Drug: Midazolam

Inclusion Criteria:

• ASA rating of I-II Mask induction of General Anesthesia

Exclusion Criteria:

• Emergency surgery Children who have developmental disabilities or chronic illness Children who have had repetitive surgeries Children who have excessive anxiety attacks or who are currently on benzopaines