Abstract
BackgroundHospital anxiety caused by strabismus surgery has an unpleasant and disturbing feeling for both children and their parents. This study aimed to determine the effect of viewing a self-produced audio-visual animation introduction on preoperative anxiety and emergence agitation of pediatric patients undergoing strabismus surgery.MethodsIn this prospective randomized study, 1 hundred children scheduled for strabismus surgery with aged 3 ~ 6 years. The children were randomly divided into 2 groups (n = 50 for each), Group A: using a self-produced audio-visual animation introduction; Group C: controlled group without audio-visual animation introduction. Children’s preoperative anxiety was determined by the modified Yale Preoperative Anxiety Scale (mYPAS) at different time points: the night before surgery(T1), at pre-anesthetic holding room(T2), and just before anesthesia induction(T3). The Spielberger State-Trait Anxiety Inventory (STAI) was used to record the anxiety of parents at T1,T2 and T3. The incidence and the degree of emergence agitation were recorded.ResultsThe mYPAS scores at T2 and T3 were higher than T1(p < 0.05) in both groups. The average score of mYPAS in Group A was significantly lower than in Group C at T2 and T3(p < 0.05). The STAI scores in Group A at T2 and T3 were significantly lower than in Group C(p < 0.05). The incidence of agitation in Group A was lower than that in Group C(p < 0.05).ConclusionsBased on the findings, viewing a self-produced audio-visual animation can effectively alleviate the preoperative anxiety for both children and their parents in pediatric strabismus surgery, and it was effective for reducing emergence agitation as well.Trial registrationThe trial was prospectively registered before patient enrollment at Chinese Clinical Trial Registry (Clinical Trial Number: ChiCTR1900025116, Date: 08/12/2019).
Highlights
Hospital anxiety caused by strabismus surgery has an unpleasant and disturbing feeling for both children and their parents
Kain and Mayes [3] reported that the postoperative pain and an increasing usage of analgesics and sedative drugs was observed in patients with intense preoperative anxiety
In Intra-Group Comparison, the modified Yale Preoperative Anxiety Scale (mYPAS) scores at T2 and T3 were higher than those at T1 in both groups (p < 0.05); In Group Comparison, there was no statistical significance between Group A and Group C in mYPAS scores at T1, the mYPAS scores of Group A at T2 and T3 were significantly lower than those in Group C (p < 0.05)
Summary
Hospital anxiety caused by strabismus surgery has an unpleasant and disturbing feeling for both children and their parents. The preoperative anxiety of preschool children may be caused by various reasons, such as the separation from parents, the adverse expectation of surgical procedures, and frequently, non-familiarity with the surgical environments and staffs [2]. Severe preoperative anxiety was observed to be related to postoperative agitation, difficulty in anesthetic induction and other negative behaviors [3,4,5]. Kain and Mayes [3] reported that the postoperative pain and an increasing usage of analgesics and sedative drugs was observed in patients with intense preoperative anxiety. The long-term psychological effects of preoperative anxiety include a negative prejudice for future surgical procedures, separation anxiety and even difficulties in school and socialization [2]. The identification and management of preoperative anxiety in preschool children are full of clinical significance in terms of preventing both physiological and psychological side effects [7]
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