title: Effect of behavioral intervention using smartphone application for preoperative anxiety in pediatric patients.
abstract: BACKGROUND
  Children and parents experience significant anxiety and distress during the preoperative period. This is important because preoperative anxiety in children is associated with adverse postoperative outcome. So we suggest behaviorally oriented preoperative anxiety intervention program based on the anesthesia and psychology with smartphone application, world-widely used.
  
  
  METHODS
  A total 120 patients (aged 1-10 years old) who were scheduled for elective surgery under general anesthesia was included in this randomized controlled trial. We randomized the patients into three groups, with using intravenous (IV) midazolam sedation (M group), with using smartphone application program (S group), and with using low dose IV midazolam plus smartphone application program (SM group). And the child anxiety was assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) at holding area, 5 min after intervention, entrance to operating room.
  
  
  RESULTS
  In all three groups, mYPAS after intervention were lower than the preoperative holding area (M group 52.8 ± 11.8 vs 41.0 ± 7.0, S group 59.2 ± 17.6 vs 36.4 ± 7.3, SM group 58.3 ± 17.5 vs 26.0 ± 3.4). A comparison of mYPAS scores between each group showed that the S group reduced anxiety lower than M group (P < 0.01), and the SM group exhibited significantly lower anxiety than the two other groups (P < 0.01).
  
  
  CONCLUSIONS
  The preoperative preparation program using smartphone application is simple and customized by individual development that effective in the reduction of preoperative anxiety.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jong-Hyuk
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Han-Kil
authors.initials: HK
authors.lastname: Jung
authors.affiliation: Department of Anesthesiology and Pain Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Gang-Geun
authors.initials: GG
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Han-Young
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Sun-Gyoo
authors.initials: SG
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Seong-Chang
authors.initials: SC
authors.lastname: Woo
keywords: Anxiety; Child; Preoperative care