Abstract
HEADPLAY personal cinema system (PCS) is a portable visual headset/visor through which movie clips may be viewed. We studied the use of HEADPLAY PCS as a distraction tool in facilitating intravenous cannulation in children undergoing anaesthesia. 60 children were enrolled into the study and randomized into 2 groups. EMLA local anaesthetic cream was used to reduce the pain associated with intravenous cannulation. Children in group 1 wore the HEADPLAY visor whereas children in group 2 were subject to conventional distraction therapy. Children were asked to rate their anxiety, pain, and satisfaction scores after intravenous cannulation. Periprocedural anxiety was also determined using the modified Yale Preoperative Anxiety Scale (mYPAS). There were no statistically significant differences in terms of pain and anxiety scores between the 2 groups. Although the satisfaction score of the children in the HEADPLAY PCS group was marginally higher compared to the conventional group, this did not hit statistical significance. 86.6% of children in group 1 reported that they would want to use the visor again for their next intravenous cannulation. We conclude that HEADPLAY PCS is a distraction tool that is acceptable to most children and can contribute towards satisfaction of the intravenous cannulation process in children.
Highlights
Intravenous cannulation without inducing anxiety or pain in the awake child is desirable but not always attainable even with topical anaesthetics applied
All children were allowed to use the HEADPLAY personal cinema system (PCS) device for a minute in the holding area outside the operating theatre (Figure 1), but it was made clear to the child and parents that consequent to randomization, the child may not have the opportunity to use the device during the first intravenous cannulation attempt
The majority of children recruited were Chinese or Malay boys with no previous intravenous cannulation experience. Of those who had previous intravenous cannulation, none of them had cried during the cannulation process
Summary
Intravenous cannulation without inducing anxiety or pain in the awake child is desirable but not always attainable even with topical anaesthetics applied. Even if the topical anaesthetic is completely effective, it may not necessarily remove anticipated anxiety associated with what is normally deemed a painful procedure. Anaesthetic induction appears to be the greatest stressor in the perioperative period [1]. Children are not routinely premedicated before anaesthesia, and intravenous cannulation is performed after EMLA cream is applied for 60 min, allowing sufficient time for it to have an effect. We sought to study if HEADPLAY PCS was as effective as conventional therapy used at our institution for facilitating the insertion of an intravenous cannula in children undergoing intravenous induction
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