Reduction of perioperative anxiety using a hand-held video game device: A randomized study

Abstract Background Inadequately controlled anxiety during medical procedures is often remembered by children manifesting in distress, post-procedural behavior changes and overall angst. The use of distraction techniques during medical procedures has been shown to reduce distress and overall anxiety. We sought to evaluate the anxiety of children/parents with and without the use of a hand-held video game for distraction during transitions in the perioperative suite in a low risk outpatient pediatric surgical setting. Methods Children (n=108), between the ages of three and ten years undergoing low-risk outpatient surgical procedures were randomized and evaluated for anxiety without (n=53) and with (n=55) the use of a handheld video game in the preoperative suite. Clinical staff observed metrics associated with anxiety at three time points up to induction. A self-reported questionnaire evaluating typical parental anxiety and their anxiety around their child's surgical procedure was completed by parents after separation. Post-operative behavioral changes were queried 48 hours, 7-days and 14-days post-procedure through phone calls to parents. Results No significant differences in demographics or comorbidities between children that had the game for distraction and those that did not were identified in our cohort. Only ADHD was found to be significantly different between the randomized groups (no game; p=0.05). Overall, while not significant, a greater mean anxiety was noted in the NG group (p=0.36); specifically, the NG group had greater mean anxiety for the separation/preoperative (p=0.05) surveys, particularly in the ‘activity’, ‘emotional expressivity’ categories. Overall, separation was found to be significantly improved with hand held video game use; parental satisfaction was also increased in the group in which games were used. Conclusion The use of hand-held games in perioperative settings are a low-cost, safe, easy to implement method to mitigate pediatric/parental anxiety in an effort to improve overall satisfaction.