By showing videos of “Barney” and “Kung Fu Panda,” researchers significantly reduced preprocedural anxiety levels in children undergoing cryotherapy for viral warts in a recent study.
In a nonblinded before-after trial in Singapore, the modified Yale Preoperative Anxiety Scale (m-YPAS) was used to measure specific features of anxious behavior in 35 children aged 2 to 6 years treated during the 10 weeks before vs. the 10 weeks after intervention.
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During each cryotherapy treatment, two freeze-thaw cycles were performed for each wart, with liquid nitrogen administered until warts turned white, with a second round of freezing performed when the whiteness dissipated. In the study’s intervention phase, patients watched either “Barney” (for children aged 2 to 4 years) or “Kung Fu Panda” (aged 5 to 6 years) while cryotherapy was explained. The programs played until treatment ended.
The study evaluated 99 cryotherapy sessions (46 without videos and 53 with videos), with 15 children undergoing cryotherapy without videos and 13 having treatment while viewing videos. Mean m-YPAS scores were 58.4 during preintervention and 37.7 during intervention (P=.005). All 15 children experienced a high anxiety score (≥30) in the nonvideo phase, while 38% (five of 13) reached that level during the video phase (P<.001).
The mean m-YPAS scores for seven childen who underwent cryotherapy without and with videos were 53.7 and 42, respectively (P=.03). The percentage of children with a high anxiety score dropped to 43% (three of seven) during the intervention phase from 86% (six of seven) during the preintervention phase (P=.25).
“Although pharmacological agents, such as benzodiazepines, are often used for preoperative sedation, nonpharmacological approaches are preferable in children,” the researchers concluded. “This study evaluated the use of the portable video player in relieving procedural anxiety among preschool children before cryotherapy, which is the most commonly performed procedure in many general dermatology offices.”