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On-line preparatory information for children and their families undergoing dental extractions under general anesthesia: A phase III randomized controlled trial

Research output: Contribution to journalArticlepeer-review

Corinne Huntington, Christina Liossi, Ana Nora Donaldson, Jonathan Timothy Newton, Patricia A Reynolds, Reham Alharatani, Marie Therese Hosey

Original languageEnglish
Pages (from-to)157-166
Number of pages10
JournalPaediatric Anaesthesia
Issue number2
Early online date27 Dec 2017
Accepted/In press26 Nov 2017
E-pub ahead of print27 Dec 2017
PublishedFeb 2018


King's Authors


BACKGROUND: Family-centered interactive on-line games are increasingly popular in healthcare, but their effectiveness for preoperative preparation needs further research. is the new on-line version of a proven nonweb-based game for children and parents/caregivers.

AIMS: The aim of this study was to evaluate if improved children's anxiety and families' satisfaction compared with controls.

METHODS: In this phase III double-blind randomized controlled trial, children/parents/caregivers received (i), (ii) standard care, or (iii) a placebo hand-washing game. The intervention and placebo games were available online for home usage and provided again on the ward before surgery. All children were accompanied by parent/caregivers at induction and observed and scored using validated measures. Stratified randomization and generalized linear models were used. An intention-to-treat approach was adopted.

RESULTS: Overall, 52/176 children had baseline "psychological disturbance." Children's anxiety increased preinduction, but there were no differences between groups (Facial Image Scale: video-standard OR = 1.08, P = .82, 95% CI [0.56, 2.1]; video-placebo OR = 0.9, P = .77 95% CI [0.46, 1.8]). There were no differences in induction behavior (visual analog scale: video mean = 3.5; standard care mean = 3.5; placebo mean = 3.7: video-standard OR = 2.0, P = .42, 95% CI [-0.6, 1.3]; video-placebo OR = 1.53, P = .65, 95% CI [-0.8, 1.1]) or induction anxiety (modified Yale Preoperative Anxiety Scale: video-standard OR 1.02, P = .97, 95% CI [0.61, 2.6]; video-placebo OR 1.38, P = .49, 95% CI [0.87, 3.81]). Families favored the intervention regarding the "child handling the visit better" (Treatment Evaluation Inventory: video-standard OR = 12; 95% CI 4.7-32; P < .001; video-placebo OR = 8.2; 95% CI 3-22; P < .001) and "improving the child's ability to cope" (Treatment Evaluation Inventory: video-standard OR = 21; 95% CI 8-56; P < .001 and video-placebo OR = 13; 95% CI 5-34; P < .001).

CONCLUSION: Families believed that a video-game preparation helped their child's perioperative anxiety, but there were no objective measures of behavioral improvement associated with this intervention.

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