Vakili Razie, Feizi Reza, Salimi Yahya, Mottahedi Mobin, Rizevandi Parisa
Department of Operating Room, School of paramedical, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Instructor of Operating Room School of Paramedicial Sciences, Arak University of Medical Sciences, Arak, Iran.
BMC Pediatr. 2025 May 15;25(1):384. doi: 10.1186/s12887-025-05718-1.
Preoperative anxiety is a significant concern for pediatric patients undergoing surgery, often leading to adverse physiological, emotional, and postoperative outcomes. Traditional pharmacological approaches, while effective, are associated with side effects, underscoring the need for age-appropriate non-pharmacological interventions. This study aimed to compare the effectiveness of play dough (PD) activities and balloon blowing (BB) in reducing preoperative anxiety in children.
This randomized controlled trial included 90 children aged 4-8 years, a developmental stage characterized by responsiveness to play-based interventions, scheduled for elective surgeries at Besat Hospital, Hamedan, Iran, between November 2023 and January 2025. Participants were randomized into three groups: PD, BB, and Control (standard care with midazolam). Anxiety levels were assessed at baseline (T0), immediately before entering the operating room (T1), and during anesthesia induction (T2) using the Modified Yale Preoperative Anxiety Scale (m-YPAS) and the Visual Analog Scale for Anxiety (VAS-A). Each intervention was administered for 15 min under direct supervision by a trained researcher. Statistical analysis included ANOVA for continuous variables and chi-square tests for categorical variables. Post hoc comparisons were performed using Tukey's method.
At T1 and T2, children in the PD and BB groups exhibited significantly lower anxiety levels compared to the Control group (P < 0.001). For m-YPAS scores at T1, the PD group mean 36.05 ± 4.28, and the BB group 35.15 ± 2.94, compared to 54.55 ± 4.05 in the Control group. Similar trends were noted at T2. VAS-A analysis further supported these findings, with the PD and BB groups showing higher proportions of mild anxiety compared to the Control group. No significant differences were detected between the PD and BB groups, indicating that both interventions were comparably effective.
PD and BB are effective non-pharmacological interventions for reducing preoperative anxiety in children. These cost-effective, engaging techniques offer safe alternatives to pharmacological treatments and promote emotional well-being. The findings support integrating age-appropriate, creative, play-based strategies into pediatric surgical care, emphasizing their potential to enhance the preoperative experience and improve outcomes. Future research should investigate long-term impacts, applicability across diverse populations, and comparative efficacy in various clinical settings.
Registered in the Iranian registry of clinical trials ( https://irct.behdasht.gov.ir ) in 19/11/2023 with the following code: IRCT20230514058183N1.
术前焦虑是接受手术的儿科患者的一个重要问题，常常导致不良的生理、情绪和术后结果。传统的药物治疗方法虽然有效，但存在副作用，这凸显了采用适合儿童年龄的非药物干预措施的必要性。本研究旨在比较玩橡皮泥（PD）活动和吹气球（BB）在减轻儿童术前焦虑方面的效果。
这项随机对照试验纳入了90名4至8岁的儿童，这一年龄段的儿童对基于游戏的干预措施有反应，于2023年11月至2025年1月在伊朗哈马丹的贝萨特医院安排进行择期手术。参与者被随机分为三组：PD组、BB组和对照组（使用咪达唑仑的标准护理）。使用改良耶鲁术前焦虑量表（m-YPAS）和焦虑视觉模拟量表（VAS-A）在基线（T0）、进入手术室前即刻（T1）和麻醉诱导期间（T2）评估焦虑水平。每项干预措施在一名经过培训的研究人员的直接监督下进行15分钟。统计分析包括对连续变量的方差分析和对分类变量的卡方检验。事后比较采用Tukey方法。
在T1和T2时，PD组和BB组儿童的焦虑水平显著低于对照组（P < 0.001）。在T1时，m-YPAS评分方面，PD组平均为36.05 ± 4.28，BB组为35.15 ± 2.94，而对照组为54.55 ± 4.05。在T2时也观察到类似趋势。VAS-A分析进一步支持了这些结果，PD组和BB组与对照组相比，轻度焦虑的比例更高。PD组和BB组之间未检测到显著差异，表明两种干预措施效果相当。
PD和BB是减轻儿童术前焦虑的有效非药物干预措施。这些具有成本效益且引人入胜的技术为药物治疗提供了安全的替代方案，并促进了情绪健康。研究结果支持将适合儿童年龄、富有创意、基于游戏的策略纳入儿科手术护理中，强调了它们在改善术前体验和提高手术效果方面的潜力。未来的研究应调查长期影响、在不同人群中的适用性以及在各种临床环境中的比较疗效。
于2023年11月19日在伊朗临床试验注册中心（https://irct.behdasht.gov.ir）注册，注册号为：IRCT2023051405818SN1。
