"Game Boy" Is an Effective Approach For Treating Anxiety in Children About to Undergo Elective Surgery

See Article in Anesthesiology News

Researchers at the University of Medicine and Dentistry of New Jersey (UMDNJ) have found that hand-held video games are as effective in treating severe anxiety in children about to undergo elective surgery as the usual approach of administering an anti-anxiety drug.

This conclusion is based on a study by Dr. Anuradha Patel and Dr's Melissa Davidson and Thomas Schieble of the Department of Anesthesiology at UMDNJ-New Jersey Medical School involving children between the ages of four and 12 years old who were about to undergo general anesthesia for surgery at UMDNJ-University Hospital.

The study will be presented on Saturday, Dec. 11, at the Postgraduate Assembly of the New York State Society of Anesthesiologists. The meeting, which begins at 10 a.m., is being held at the Marriott Hotel in New York City.

"Going into into the operating room can be an extremely anxious time for children even though they are with their parents," said Dr. Henry L. Bennett, associate professor in the Department of Anesthesiology at the UMDNJ-New Jersey Medical School. "Over the years we have tried a number of activities from watching television to reading stories to using coloring books to help alleviate their stress, but none of these approaches provided enough distraction to lessen the childrens' anxiety."

If the children get so anxious they act out, the only other option was to administer oral midazolam, Dr. Bennett said, "but the problem is that this drug can produce a ‘drug hangover' which may last longer that the effect of the anesthesia itself, and, parents may not be comfortable with their child being drugged."

The idea of using a Game Boy as a new approach for treating anxiety came from Dr. Anuradha Patel, a pediatric anesthesiologist at the UMDNJ-New Jersey Medical School, because she had seen how absorbed her friend's seven-year-old son is when he's playing with his Game Boy.

Collecting the needed Game Boys and games became the community service project of the Eagle Scout troop led by Christopher Walsh from Allendale, NJ.

The randomized controlled study, which took place between February and October of this year, involved 78 children. The researchers used the modified Yale Pre-Operative Anxiety Scale, an observational instrument that quantifies children's anxiety, to determine when to intervene with a pediatric patient.

The children between the ages of 4 and 12 were randomly assigned to one of three groups. All three groups of children had their parents with them throughout the period until loss of consciousness from breathing an anesthetic gas through a mask in the operating room.

One group had only their parents with them to help cope with their anxiety; one group was also given an oral dose of midazolam about 30 minutes before anesthesia; and each child in the third group was given a Game Boy About 30 minutes prior to anesthesia.

"The results of this study showed that the most dramatic difference in anxiety was the group that had the Game Boy right up until the anesthesia took effect," Dr. Bennett said.

The median change in anxiety for the Game Boy group was zero while for the midazolam group the increase was 7.5, in accordance with the anxiety scale. For the group who only had parental presence as a calming factor, the increase was 17.5.

"We would like to introduce the use of Game Boys in the pre-anesthesia waiting areas and allow the children to stay absorbed in the GameBoy right up until anesthesia," he said.

Officials at Nintendo, the manufacturer of Game Boy, have installed game stations in pediatric play rooms at hospitals nationwide, but said they had never heard of providing Game Boys to children to help with preoperative anxiety.


The UMDNJ-New Jersey Medical School is one of three medical schools of the University of Medicine and Dentistry of New Jersey. UMDNJ comprises New Jersey's only medical schools, the state's only dental school, a nursing school, a graduate school of biomedical sciences, a school of health related professions and a school of public health on campuses in Newark, Piscataway/New Brunswick, Camden, Stratford and Scotch Plains. It is affiliated with more than 200 health care and educational institutions throughout the state.