Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 4947-4955
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.4947
Influence of static cartoons combined with dynamic virtual environments on preoperative anxiety of preschool-aged children undergoing surgery
Ya-Lin Zhang, Qi-Ying Zhou, Peng Zhang, Lin-Feng Huang, Li Jin, Zhi-Guo Zhou
Ya-Lin Zhang, Li Jin, Department of Pediatrics, Hangzhou Ninth People’s Hospital, Hangzhou 311225, Zhejiang Province, China
Qi-Ying Zhou, Peng Zhang, Pediatric Intensive Care Unit, Hangzhou Children’s Hospital, Hangzhou 310014, Zhejiang Province, China
Lin-Feng Huang, Intensive Care Unit, Hangzhou Ninth People’s Hospital, Hangzhou 311225, Zhejiang Province, China
Zhi-Guo Zhou, Department of Surgical Anesthesia, Hangzhou Children’s Hospital, Hangzhou 310014, Zhejiang Province, China
Author contributions: Zhang YL designed the research and wrote the first draft of the manuscript; Zhang YL, Zhou QY and Zhang P contributed to conceiving the research and analyzing data; Zhang YL, Huang LF, Jin L and Zhou ZG conducted the analysis; Zhang YL and Zhou ZG provided guidance for the research; All authors reviewed and approved the final manuscript.
Supported by Hangzhou Medical and Health Technology Project, No. OO20191141.
Institutional review board statement: This study was approved by the Ethic Committee of Hangzhou Children’s Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
Data sharing statement: All data and materials are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Guo Zhou, MM, Doctor, Department of Surgical Anesthesia, Hangzhou Children’s Hospital, No. 195 Wenhui Road, Gongshu District, Hangzhou 310014, Zhejiang Province, China. 620zzg@163.com
Received: March 25, 2024
Revised: May 22, 2024
Accepted: June 5, 2024
Published online: August 6, 2024
Processing time: 98 Days and 19.8 Hours
Abstract
BACKGROUND

Preschoolers become anxious when they are about to undergo anesthesia and surgery, warranting the development of more appropriate and effective interventions.

AIM

To explore the effect of static cartoons combined with dynamic virtual environments on preoperative anxiety and anesthesia induction compliance in preschool-aged children undergoing surgery.

METHODS

One hundred and sixteen preschool-aged children were selected and assigned to the drug (n = 37), intervention (n = 40), and control (n = 39) groups. All the children received routine preoperative checkups and nursing before being transferred to the preoperative preparation room on the day of the operation. The drug group received 0.5 mg/kg midazolam and the intervention group treatment consisting of static cartoons combined with dynamic virtual environments. The control group received no intervention. The modified Yale Preoperative Anxiety Scale was used to evaluate the children’s anxiety level on the day before surgery (T0), before leaving the preoperative preparation room (T1), when entering the operating room (T2), and at anesthesia induction (T3). Compliance during anesthesia induction (T3) was evaluated using the Induction Compliance Checklist (ICC). Changes in mean arterial pressure (MAP), heart rate (HR), and respiratory rate (RR) were also recorded at each time point.

RESULTS

The anxiety scores of the three groups increased variously at T1 and T2. At T3, both the drug and intervention groups had similar anxiety scores, both of which were lower than those in the control group. At T1 and T2, MAP, HR, and RR of the three groups increased. The drug and control groups had significantly higher MAP and RR than the intervention group at T2. At T3, the MAP, HR, and RR of the drug group decreased and were significantly lower than those in the control group but were comparable to those in the intervention group. Both the drug and intervention groups had similar ICC scores and duration of anesthesia induction (T3), both of which were higher than those of the control group.

CONCLUSION

Combining static cartoons with dynamic virtual environments as effective as medication, specifically midazolam, in reducing preoperative anxiety and fear in preschool-aged children. This approach also improve their compliance during anesthesia induction and helped maintain their stable vital signs.

Keywords: Preschool, Children, Static cartoons combined with dynamic virtual environments, Preoperative anxiety, Compliance, Anesthesia induction

Core Tip: Preschoolers are particularly prone to anxiety when they are about to undergo anesthesia and surgery. As pharmacological and non-pharmacological interventions have disadvantages, this study explored a more suitable intervention to address preoperative anxiety and anesthesia induction cooperation in preschool-aged children undergoing surgery. This study examined and validated factors such as anxiety level, degree of cooperation during anesthesia induction, and vital signs. Static cartoons combined with dynamic virtual environments were as effective as midazolam in reducing preoperative anxiety and fear in preschool-aged children, improving cooperation with anesthesia induction, and maintaining stable vital signs.