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Review
. 2024 Feb 19:12:1353508.
doi: 10.3389/fped.2024.1353508. eCollection 2024.

Preoperative anxiety management in pediatric patients: a systemic review and meta-analysis of randomized controlled trials on the efficacy of distraction techniques

Muhammad Saqlain Mustafa  1 , Muhammad Ashir Shafique  1 , Syeda Dua E Zehra Zaidi  1 , Amna Qamber  1 , Burhanuddin Sohail Rangwala  1 , Aftab Ahmed  2 , Syeda Mahrukh Fatima Zaidi  3 , Hussain Sohail Rangwala  1 , Muhammad Musab Nafees Uddin  1 , Mirha Ali  1 , Mohammad Arham Siddiq  1 , Abdul Haseeb  1
Affiliations
Review

Preoperative anxiety management in pediatric patients: a systemic review and meta-analysis of randomized controlled trials on the efficacy of distraction techniques

Muhammad Saqlain Mustafa et al. Front Pediatr. .

Abstract

Background: This study addresses the pervasive issue of heightened preoperative anxiety in healthcare, particularly among pediatric patients. Recognizing the various sources of anxiety, we explored both pharmacological and nonpharmacological interventions. Focusing on distraction techniques, including active and passive forms, our meta-analysis aimed to provide comprehensive insights into their impact on preoperative anxiety in pediatric patients.

Methods: Following the PRISMA and Cochrane guidelines, this meta-analysis and systematic review assessed the efficacy of pharmaceutical and distraction interventions in reducing pain and anxiety in pediatric surgery. This study was registered on PROSPERO (CRD42023449979).

Results: This meta-analysis, comprising 45 studies, investigated pharmaceutical interventions and distraction tactics in pediatric surgery. Risk of bias assessment revealed undisclosed risks in performance and detection bias. Distraction interventions significantly reduced preoperative anxiety compared to control groups, with notable heterogeneity. Comparison with Midazolam favored distraction techniques. Subgroup analysis highlighted varied efficacies among distraction methods, with a notable reduction in anxiety levels. Sensitivity analysis indicated stable results. However, publication bias was observed, suggesting a potential reporting bias.

Conclusion: Our study confirms distraction techniques as safe and effective for reducing pediatric preoperative anxiety, offering a valuable alternative to pharmacological interventions.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=449979, PROSPERO [CRD42023449979].

Keywords: distraction techniques; nonpharmacological interventions; pediatric preoperative anxiety; pediatric surgery; systemic review and meta-analysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The PRISMA flowchart.
Figure 2
Figure 2
Illustrates the influence of distraction interventions on preoperative anxiety in children undergoing surgery. The figure compares the outcomes between the Intervention group and the control group at the entrance of the Operation Room.
Figure 3
Figure 3
Distraction technique vs. midazolam use on preoperative anxiety in children undergoing surgery.
Figure 4
Figure 4
Subgroup analysis of different distraction techniques. The figure compares the outcomes between the Intervention group and the control group at the entrance of the Operation Room.
Figure 5
Figure 5
Sensitivity analysis of figure 1—intervention (distraction) and control.
See this image and copyright information in PMC

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