The effect of play distraction on anxiety before premedication administration: a randomized trial

Study objective: The majority of children scheduled to undergo surgery experience substantial anxiety in the preoperative holding area before induction of anesthesia. Pharmacological interventions aimed at reducing perioperative anxiety are paradoxically a source of stress for children themselves. Midazolam is frequently used as premedication, and the formula of this drug in Turkey is bitter. We aimed to assess the role of distraction in the form of playing with play dough (Play-Doh) on reducing premedication anxiety in children. Design: Prospective randomized clinical trial. Setting: Preoperative holding area. Patients: One hundred four healthy children aged 3 to 7 years scheduled to undergo elective surgery were enrolled into the study. Interventions: All children routinely receive sedative premedication (oral midazolam) before anesthesia. Children were randomized to 2 groups to receive either play dough (group PD) (n = 52) or not (group C) (n = 52) before administration of oral premedication. Measurements: Children's premedication anxiety was determined by the modified Yale Preoperative Anxiety Scale (mYPAS). Main results: The difference in mYPAS scores between groups at To (immediately after entering the preoperative holding area) was not significant (P =.876). Compared with group C, group PD was associated with lower mYPAS scores at T-1 and T-2 (P < .001). In group PD, mYPAS scores were significantly lower at both T1 and T2 as compared with the scores at To (P < .001); they were similar between T1 and T2 (P > .001). Conclusion: This study showed that distraction in the form of playing with play dough facilitated administration of oral midazolam in young children. (C) 2016 Published by Elsevier Inc.