Effect of a game‐based intervention on preoperative pain and anxiety in children: A systematic review and meta‐analysis

BACKGROUND: Games are increasingly being used as a means of alleviating pain and anxiety in paediatric patients, in the view that this form of distraction is effective, non‐invasive and non‐pharmacological. AIMS: To determine whether a game‐based intervention (via gamification or virtual reality) during the induction of anaesthesia reduces preoperative pain and anxiety in paediatric patients. METHODS: A systematic review with meta‐analysis of randomised controlled trials was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines and using RevMan software. The review was based on a search of the EMBASE, CINAHL, Medline, SciELO and Scopus databases, conducted in July 2021. No restriction was placed on the year of publication. RESULTS: 26 studies were found, with a total study population of 2525 children. Regarding pain reduction, no significant differences were reported. For anxiety during anaesthesia induction, however, a mean difference of −10.62 (95% CI −13.85, −7.39) on the Modified Yale Preoperative Anxiety Scale, in favour of game‐based intervention, was recorded. CONCLUSIONS: Game‐based interventions alleviate preoperative anxiety during the induction of anaesthesia in children. This innovative and pleasurable approach can be helpful in the care of paediatric surgical patients. RELEVANCE TO CLINICAL PRACTICE: In children, preoperative management is a challenging task for healthcare professionals, and game‐based strategies could enhance results, improving patients’ emotional health and boosting post‐surgery recovery. Distractive games‐based procedures should be considered for incorporation in the pre‐surgery clinical workflow in order to optimise healthcare.