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    Smartphone-based behavioural intervention alleviates children's anxiety during anaesthesia induction
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    Abstract:
    Preoperative anxiety negatively influences children's anaesthetic and surgical experience, and results in postoperative complications, such as emergence delirium and behavioural changes. Nonpharmacological management using alternative therapies that alleviate psychological stress can be as important as pharmacological ones in reducing children's anxiety. Nevertheless, their validity as an effective anxiety-reducing strategy in children remains controversial.To verify whether nonpharmacological strategies, that is, leaflet and distraction with smartphone application presented to parents/guardians and children, respectively, were effective in preventing children's anxiety during anaesthesia induction.Randomised clinical trial.A tertiary care teaching hospital.In total, 84 children (aged 4 to 8 years; American Society of Anesthesiologists I and II) undergoing minor-to-moderate elective surgical procedures and their parents/guardians.Children were randomised into four groups: control group, in which the parent/guardian was verbally informed about the anaesthetic procedure; the informed group, in which the parent/guardian was also provided with an information leaflet about the anaesthetic procedure; the smartphone group, in which the parent/guardian was verbally informed and the child received a smartphone application to play with while in the holding area before entering the operating room and the smartphone and informed group, in which the parent/guardian also received an information leaflet and the child, a smartphone application to play with while in the holding area before entering the operating room.Children's anxiety at two time points: in the holding area of the surgical centre and in the operating room during induction of anaesthesia by facemask.Median (IQR) anxiety levels were greater at time point operating room for children in the control group (55.0; range: 30.0 to 68.4) than in the other groups: informed group, 28.4 (23.4 to 45.0); smartphone group, 23.4 (23.4 to 30.0); smartphone and informed group, 23.4 (23.4 to 25.9).The behavioural distraction strategies using smartphones were effective in preventing an increase in children's anxiety during anaesthesia induction.clinicaltrials.gov identifier: NCT02246062.
    Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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