Virtual Reality Glasses versus Midazolam in Alleviation of Child’s Anxiety during Dental Rehabilitation: Randomized Controlled Clinical Trial

Abstract

Objective: To evaluate virtual reality glasses versus premedication with oral midazolam, and their effect on separation anxiety and postoperative behavioural changes in children experiencing dental rehabilitation under general anaesthesia. Introduction: Several children suffer anxiety when experiencing dental rehabilitation under general anaesthesia, which may be caused by separation from parents, and negative anticipation of surgical procedures. Midazolam (MDZ) is a generation of Benzodiazepines that have been widely used as a premedication. Whereas distraction is a common technique used to reduce pain and anxiety during short invasive procedures. Methodology: This was a randomized clinical trial; children aged 4-6 years who were healthy, uncooperative, and planned to be treated using general anaesthesia were randomly distributed between two groups (Group I), using the Virtual glasses and (Group II), given oral midazolam. The baseline heart rate (HR) was recorded twice. Ease of separation was assessed for all the participants using the Parental Separation Anxiety Scale (PSAS). The Postoperative behavioural changes were scored using (PHBQ) Questionnaire after 24 hours and 14 days after the operation. Results: Regression analysis showed that the type of intervention was non-significantly associated with the acceptability of separation. Males showed significantly less acceptable separation than females. There was a statistically significant increase in the heart rate readings in both groups when compared before and after separation. The parent-reported child morbidity following the surgery showed no significant difference except when regarding the children “who were upset at mentioning doctors, dentists or hospitals” where (P=0.000). Conclusion: VR and premedication with oral midazolam were both effective strategies for controlling preoperative anxiety in children during parental separation, with lots of advantages when using the VR distraction approach.