Handheld-multimedia Versus Oral Midazolam in Pediatric on Perioperative Anxiety

  • STATUS
    Recruiting
  • participants needed
    150
  • sponsor
    Universitair Ziekenhuis Brussel
Updated on 16 February 2024
anxiety
anesthesia
midazolam
premedication
dental care
adenoidectomy
circumcision
tonsillectomy
oral midazolam
pediatric
elective circumcision

Summary

The first goal of this study is to compare the efficacy and safety between anxiolysis by multimedia-distraction with an IPAD versus anxiolysis by premedication with midazolam prior to the induction. Secondly to evaluate the need for midazolam-premedication in pediatric day-care patients induced by inhalational anesthesia.

Description

Perioperative anxiety in children is a common multifactorial influenced and triggered entity with an incidence as high as 50%. Especially (mask)induction of anesthesia is considered one of the most stressful experiences for a child undergoing surgery. A common practice worldwide to diminish the level of anxiety prior to anesthesia is premedication with the benzodiazepine midazolam in order to improve cooperation during induction.

Premedication with midazolam has a primary purpose to reduce preoperative anxiety and has inherent to a benzodiazepine its sedative effects. Although these effects are implied, negative effects of premedication: respiratory complications, paradoxical negative behavior has been reported. Although alternative medications have been studied, studies for non-pharmacological anxiety-reduction remain limited.

Non-pharmacological anxiety-reduction by distraction including Tablet or IPAD-multimedia might be a readily available alternative for midazolam premedication. Potentially limiting the use of psychoactive agents, limiting the need for preoperative sedation and therefore possibly decrease secondary respiratory complications in pediatric surgical day-care.

Objective

The first goal of this study is to compare the efficacy and safety between anxiolysis by multimedia-distraction with an IPAD versus anxiolysis by premedication with midazolam prior to the mask-induction of anesthesia. Secondly to evaluate the need for midazolam premedication in pediatric day-care surgery patients induced by inhalational anesthesia.

Details
Condition Tonsillectomy, Circumcision, Ambulatory Surgery, Dental Care, Preanesthetic Medication, inhalation anesthesia, Perioperative Anxiety
Age 1years - 8years
Treatment Midazolam oral solution, IPAD
Clinical Study IdentifierNCT04273035
SponsorUniversitair Ziekenhuis Brussel
Last Modified on16 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

Age 1 year and <8 years old
ASA class 1 or 2 (American Society of Anesthesiologists Physical Status Classification System)
Elective circumcision, tonsillectomy or adenoidectomy, dental care procedure in day-care
Written informed consent by the legal parents or caretaker

Exclusion Criteria

Parents of the patient wish not to participate with the study
Parents are not able to give informed consent (language barrier, legally incapable)
A contraindication for the use of premedication with midazolam
A known allergy to midazolam
A contraindication for premedication in general
A contraindication for the use of a gas-induction/gas-anesthesia
A contraindication for the use of sevoflurane
A known mental retardation of the child
Preoperative behavioral disturbances and psychiatric disorders
Any use of psychoactive medication
A known photosensitive epilepsy
A previous operation within 3 months of the time of scheduled operation
Any other contraindication for the use of the study medication
Previous history of multiple surgery (>3)
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