PDF(Pubmed)
Abstract：
Evidence shows tablet-based interactive distraction (TBID) is effective as a preoperative anxiolytic in pediatric patients. TBID involves age-appropriate video games that have been preloaded onto a tablet (TAB) and subsequently given to a pediatric patient before the administration of anesthesia. The purpose of this study is to provide a comprehensive analysis of previous studies that have investigated the use of TBID to minimize preoperative anxiety. The literature criteria for this systematic review included randomized controlled trials and prospective studies that used TBID as a method to reduce preoperative anxiety in pediatric patients aged 1-12 years. Data extraction concentrated on the patient population to which the TABs were introduced, the method of TAB administration, how anxiety was evaluated, who completed the evaluations, and the results of each publication. This chosen data set is to systematically understand if TBID is effective and to identify the most practical ways to implement TBID. Collected data from the selected publications were entered into a table. For this systematic review, 27 publications from 2006 to 2023 were screened for eligibility. These studies were selected using a combination of MeSH terms and a Title-Abstract filter in PubMed, Embase, and Scopus. These data represented 475 total patients (T) and 249 patients who implemented TAB use. The other 226 patients were used as various control groups. The outcome of each study is summarized and placed into a table. This study is expected to provide an overall assessment of the effectiveness of TBID and proposed guidelines for clinicians to incorporate TAB use into preoperative protocols. The time to give the TAB to the children impacts its efficiency. This review accentuates the effectiveness of utilizing TBID to mitigate preoperative anxiety in pediatric patients based on a comprehensive analysis of multiple prior studies conducted in diverse healthcare settings, including pediatric hospitals and surgical centers. TAB use demonstrated an effective reduction in perioperative anxiety, emergence of delirium, and time to discharge, increasing parental satisfaction compared to midazolam. These results are likely replicable across a broader range of clinical settings, provided the intervention parameters, such as the timing of TAB introduction and the personalization of content to patient interests, are carefully adapted to each situation. The anxiety evaluations of patients using TBID varied based on the evaluator. Therefore, future research should analyze if perceived anxiety in patients using TABs is consistent or not among the evaluators. The impact of this TBID review has the potential to set a new benchmark for managing pediatric preoperative anxiety, with significant implications for healthcare quality and patient satisfaction.
摘要：
有证据表明，基于片剂的交互式分散（TBID）作为儿科患者的术前抗焦虑药是有效的。TBID涉及适合年龄的视频游戏，这些游戏已预装到平板电脑（TAB）上，随后在麻醉给药之前给予儿科患者。这项研究的目的是对以前的研究进行全面分析，这些研究调查了使用TBID来最大程度地减少术前焦虑。本系统综述的文献标准包括随机对照试验和前瞻性研究，这些研究使用TBID作为减轻1-12岁儿科患者术前焦虑的方法。数据提取集中在引入TAB的患者群体上，TAB管理的方法，如何评估焦虑，谁完成了评估，以及每个出版物的结果。该选择的数据集将系统地了解TBID是否有效，并确定实现TBID的最实用方法。从所选出版物收集的数据被输入到表格中。对于这项系统审查，对2006年至2023年的27份出版物进行了资格筛选。这些研究是使用MeSH术语和PubMed中的标题摘要过滤器的组合选择的，Embase,还有Scopus.这些数据代表了475名患者（T）和249名实施TAB使用的患者。其他226例患者用作不同的对照组。每个研究的结果被总结并放入表格中。这项研究预计将提供对TBID有效性的全面评估，并为临床医生将TAB使用纳入术前方案的拟议指南。将TAB交给孩子的时间会影响其效率。这篇综述基于对在不同医疗机构进行的多项先前研究的综合分析，强调了利用TBID减轻儿科患者术前焦虑的有效性。包括儿科医院和手术中心。TAB的使用证明了围手术期焦虑的有效减少，出现谵妄,和出院时间，与咪达唑仑相比，提高了父母的满意度。这些结果可能在更广泛的临床环境中复制，提供了干预参数，例如TAB引入的时机和针对患者兴趣的内容个性化，仔细地适应每种情况。使用TBID对患者的焦虑评估因评估者而异。因此,未来的研究应分析使用TABs的患者的焦虑感在评估者之间是否一致.这项TBID审查的影响有可能为管理儿科术前焦虑树立新的基准，对医疗质量和患者满意度有重大影响。
