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NEWARK, N.J. — Children gowned and waiting for surgery, many of them scared and crying, can be calmed better with hand-held video games than with sedatives, researchers have found.
Even parents could not placate anxious children as well as Game Boys, a hand-held electronic created by Nintendo, which children carried into operating rooms and often played until they felt the effects of anesthesia.
The study done at the University of Medicine & Dentistry of New Jersey, was presented last month to the New York State Society of Anesthesiologists.
Anesthesiologists who work with children have long tried to reduce the trauma of surgery, trying games, books and music — usually with little success.
Pediatric anesthesiologist Anuradha Patel said about 40 percent of hospitals use an anti-anxiety drug, most often midazolam, or Versed. But many parents don't want their children on these drugs. The effects of the sedative may outlast that of anesthesia, lengthening time in the recovery room. Some children get agitated as the sedative wears off.
Patel, looking for new ways to make surgery less frightening, noticed how immersed a friend's child became with his Game Boy.
"She would come to my house with her son playing his Game Boy. I thought to myself, 'We could be doing anything and he wouldn't be paying attention.' "
A nurse later brought an old Game Boy to the operating room. Patel saw how kids often forget their fears as they played.
She decided to test her theory. Patel followed 78 children, ages 4-12, right up to the moment of their surgery at University Hospital in Newark.
She divided the children randomly into three groups of 26. All had their parents with them. One group had only their parents to help them cope; another group also was given an oral dose of midazolam 30 minutes before surgery; and children in the third group were given a Game Boy 30 minutes before surgery.
The researchers used the well-known Yale Pre-Operative Anxiety Scale, which measures fidgeting, weeping, crying, agitation and other symptoms of anxiety on a scale of 0 to 100.
The results were striking.
As surgery approached, the distress levels of the parent-only children jumped an average of 17.5 points on the anxiety scale. Anxiety in the children given the sedative jumped 7.5 units. But the Game Boy children showed no increase in anxiety at all.
This is a dramatic shift compared with the generalized increase in anxiety in the other groups," said Henry Bennett, a member of the study team. Girls were comforted by Game Boys as well as boys.
Patel and Bennett said they expect other hospitals to begin using Game Boys, which are also convenient for operating-room staff since, unlike drugs that wear off, they continue to be effective if surgery is postponed.
"The beauty of the Game Boy is that it's portable and easy to implement," said Patel.
The ability of electronic games to mesmerize children, even those in the midst of a traumatic experience, may give pause to some parents whose children play the games frequently.
"This study says that Game Boys are more powerful than a sedative," said Michael Rich, a pediatrician at the Center on Media and Children's Health at Harvard Medical School in Boston. "It gives you an idea why they get that vacant look in their eyes."
Rich does not oppose using Game Boys to help children cope with surgery, but he said the study raises questions about the power of electronic games and their use by children in general.
