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Apps ‘as effective as sedatives’ in children needing anaesthetics before surgery

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Allowing children to use iPads to distract them before surgery requiring general anaesthesia is as effective at lowering their anxiety as conventional sedatives, according to a French study.

In addition, parental satisfaction and quality of anaesthesia induction was higher in children using iPads, said the researchers from the Hopital Mere Enfant in Bron.

“Child and parental anxiety before anaesthesia are equally blunted by midazolam or use of the iPad”

Dominique Chassard

They compared the effects of the sedative midazolam in pre-medication with age-appropriate game apps – on an iPad tablet – among children aged 4-10 years during and after ambulatory surgery.

Children were allocated to one of the two groups of 58. One group received midazolam 0.3mg/kg, while those in the other one were given an electronic tablet 20 minutes before anaesthesia.

Child anxiety was measured by two independent psychologists at arrival at hospital, at separation from the parents, during induction and in the post-anaesthesia care unit (PACU).

Parental anxiety was measured at the same time points except during induction as they were not present at that point.

Anaesthetic nurses ranked from 0 (not satisfied) to 10 (highly satisfied) the quality of induction of anaesthesia.

Then, 30 minutes after the child received their last dose of nalbuphine anaesthestic or 45 minutes after arrival in the PACU, the children were transferred to the ambulatory surgery ward where parental anxiety and children anxiety were again evaluated for the final time.

In addition, parents’ satisfaction with the anaesthesia procedure was rated from 0 to 10.

The researchers found both parental and child anxiety levels to be similar in both groups, with a similar pattern of evolution.

Both parents and nurses found anaesthesia more satisfying in the iPad group.

Lead study author Dr Dominique Chassard said: “Our study showed that child and parental anxiety before anaesthesia are equally blunted by midazolam or use of the iPad.

“However, the quality of induction of anaesthesia, as well as parental satisfaction, were judged better in the iPad group,” he said.

“Use of iPads or other tablet devices is a non-pharmacologic tool which can reduce perioperative stress without any sedative effect in paediatric ambulatory surgery,” he added.

The study findings were presented last weekend at the World Congress of Anaesthesiologists in Hong Kong.

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