The Effect of Computer Tablets on the Need for Medical Anxiolysis in Children in an Ambulatory Surgical Center

BackgroundPreoperative anxiety is common in children undergoing surgery. When anxiety is identified or suspected, there are several strategies typically used to manage it. Perhaps the most common is anxiolytic premedication or parental presence at induction. Medications such as midazolam have been a...

Full description

Saved in:
Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-07, Vol.15 (7), p.e42553-e42553
Main Authors: Farlie, Kerry H, Austin, Thomas M, Gonzalez, Sandra N, Edwards, Christopher M, Gravenstein, Nikolaus, Dooley, Fred C
Format: Article
Language:English
Subjects:
Airway management
Anesthesiology
Anxiety
Computer & video games
Computers
Delirium
General anesthesia
Length of stay
Patients
Pediatrics
Portable computers
Recovery (Medical)
Regression analysis
Surgery
Time series
Tranquilizers
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BackgroundPreoperative anxiety is common in children undergoing surgery. When anxiety is identified or suspected, there are several strategies typically used to manage it. Perhaps the most common is anxiolytic premedication or parental presence at induction. Medications such as midazolam have been associated with adverse effects, such as a slower wakeup, and require timing of administration, while parental presence can be disturbing to the parent and divert the attention of the operating room team. A more recent option is distraction via electronic tablets. The purpose of this study was to retrospectively investigate and quantify any change in the use of midazolam, the most common anxiolytic approach at our institution, and any change in the length of time in the post-anesthesia care unit (PACU) following the introduction of tablet computers to a pediatric ambulatory surgical center.MethodsWe conducted an IRB-approved retrospective chart review of 13,790 pediatric patients ages one to 18 undergoing outpatient elective surgeries at the University of Florida (UF) Children’s Surgical Center over a five-year period. A univariate analysis was conducted using the Fisher’s Exact test and interrupted time series analysis to determine differences between midazolam administration and PACU times, with interruption occurring at tablet implementation. A multivariable analysis and sensitivity analyses were performed to confirm the findings of the univariate analysis.ResultsOn univariate analysis, tablet availability was associated with both a decreased preoperative oral midazolam administration (odds ratio (OR) 0.158, 95% confidence interval (CI): 0.140 to 0.179, P-value
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.42553