What’s the least-worst way to prevent young kids from becoming jittery as they are about to have surgery? This new experiment plays with that question:
“The Effectiveness of Transport in a Toy Car for Reducing Preoperative Anxiety in Preschool Children: A Randomised Controlled Prospective Trial,” P.P. Liu, Y. Sun, C. Wu, W.H. Xu, R.D. Zhang, J.J. Zheng, Y. Huang, Y.Q. Chen, M.Z. Zhang, and J.Z. Wu, British Journal of Anaesthesia, vol. 121, no. 2, August 2018, pp. 438-444. The authors, at Shanghai Jiao Tong University, Shanghai, China, and the Cincinnati Children’s Hospital Medical Center, USA, explain:
This study was designed to determine whether transport of a paediatric inpatient in a children’s ride-on toy car has an effect on perioperative levels of anxiety compared with transport on a hospital gurney with or without oral midazolam premedication….
108 children aged 2–5 yr with congenital heart disease and undergoing first surgical correction were randomly allocated to one of three groups: Group C (transport in a children’s ride-on car), Group G (transport on a gurney without premedication), or Group M (transport on a gurney and received premedication of oral midazolam 0.5 mg kg−1)….
Three categories of interventions have been used to reduce preoperative anxiety: sedatives premedication, parental presence during induction of anaesthesia, and hospital-based preoperative preparation programs. Midazolam premedication is regarded as a reliable strategy in reducing preoperative anxiety, but it can be associated with a number of untoward consequences, such as paradoxical reaction, delayed patient discharge in ultrashort procedures, and some operational drawbacks.7 Parental presence with the child until the completion of anaesthesia inhalation induction is popular in the UK and USA, and it increases the parents’ satisfaction and the child’s cooperation. But clinically, it is less practical in overpopulated Asian countries….
Conclusions—Transport in a ride-on toy car can relieve preoperative anxiety in preschool children undergoing surgery to a comparable degree as midazolam.
BONUS QUESTION (unrelated): What is the horsepower of a toy car?