Awaiting surgery can be stressful, especially for children, so doctors often turn to sedatives to calm their young patients. However, a new study has discovered that sedatives may not be necessary as the use of video games to distract the children can be just as effective at lowering their anxiety.
The study comes from Dr Dominique Chassard, EPICIME, Hopital Mere Enfant, Hospices Civils de Lyon in Bron, France, along with other researchers. The study authors will present their findings at the World Congress of Anaesthesiologists (WCA) in Hong Kong, which runs from August 28th until September 2nd. Medical staff sometimes distract their young patients with mobile interactive tools, such as a game on an iPad or other tablet, and the researchers wanted to compare the effects of these electronics versus using a traditional sedative.
For their study, the researchers studied 112 French children between the ages of four and ten, along with their parents, before, during, and after day surgery. They gave 54 children the sedative midazolam and 58 children an iPad twenty minutes before anesthesia, comparing anxiety levels in both groups as well as anxiety levels of their parents. Psychologists used a scale to assess the child’s anxiety levels as they arrived at the hospital, as they were separated from their parents, as they were given anesthesia, and as they recovered from anesthesia after their surgery. Parent anxiety levels were measured at arrival, separation, and recovery as well. The researchers also assessed the child’s behavior changes after surgery and asked the nurses to assess the effectiveness of the anesthesia.
It would make sense that a sedative would calm a child more than using an iPad, but this is not what the researchers found. Surprisingly, anxiety levels in the children using an iPad seemed to be similar to anxiety levels in the children who had a sedative before their anesthesia. The anxiety levels in both groups of kids also followed a similar pattern before and after the surgery. Not only that, but the parents and nurses judged the anesthesia to be better in the group of children using an iPad. It seems that allowing a child to use an electronic device before surgery can be just as effective as, or even more effective than, giving them a sedative.
As surprising as the study results may be, they open up new ways for hospital staff to calm their young patients. While sedative drugs may have been the traditional way to calm a child before surgery, any drug can potentially have side effects and interactions with other drugs. Midazolam in particular can be risky when used to sedate babies, since they are especially sensitive to its effects, and in others the drug can lower blood pressure and reduce breathing. The use of electronic devices such as tablets could help reduce the need for these drugs, reducing any risk associated with their use.
The study results could also be helpful for other areas of medical care. Most children are not fans of needles, so parents and doctors could potentially use electronic video games to distract a child when they get their necessary vaccinations. Electronic devices could also potentially help children cope with cancer treatments, dialysis, or other stressful medical procedures. Parents may not be surprised by the study findings, as they often use electronics to distract their kids in everyday life.
Midazolam, including the brand name Versed, is a sedative which can help reduce anxiety or make a patient drowsy before surgery. This drug can also help to maintain anesthesia during the surgery itself, helping keep the patient unconscious during the procedure. Midazolam affects the brain, triggering short-term memory loss, relaxing muscles, inducing sleepiness, and reducing anxiety, which helps to calm the patient as they face the stress of surgery and to help them forget any pain or discomfort they may have experienced during the surgery. Medical staff usually administer midazolam intravenously, which is directly into a vein, and it can start working within five minutes and last for one to six hours. The drug was developed in 1975 and has been in use since 1976.