Non-pharmacological Interventions for Preoperative Anxiety in Children: A Systematic Review and Network Meta-Analysis.
Summary
Across 36 RCTs (n=3,182), non-pharmacological strategies reduced pediatric preoperative anxiety, with psychological plus digital health interventions ranking highest. The combination of parental presence during induction and video games consistently outperformed most other approaches.
Key Findings
- Psychological plus digital health interventions ranked highest for reducing preoperative anxiety.
- Parental presence during induction combined with video games outperformed most comparators.
- Benefits were consistent across subgroup and sensitivity analyses.
Clinical Implications
Adopt structured parental presence with interactive video games as first-line non-pharmacological anxiety reduction in pediatric preoperative pathways; integrate digital tools and staff training.
Why It Matters
Provides comparative effectiveness evidence to guide pediatric perioperative practice, prioritizing scalable, low-risk interventions. Findings can be rapidly integrated into preoperative workflows.
Limitations
- Heterogeneity in intervention formats and anxiety measurement tools.
- Potential risk of bias across included trials and limited long-term outcomes.
Future Directions
Standardize outcome measures, evaluate implementation fidelity, and test hybrid models combining digital tools with parental presence in pragmatic multicenter RCTs.
Study Information
- Study Type
- Systematic Review/Meta-analysis
- Research Domain
- Treatment
- Evidence Level
- I - Network meta-analysis of randomized controlled trials
- Study Design
- OTHER