{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:25:17Z","timestamp":1790166317647,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,7,17]],"date-time":"2014-07-17T00:00:00Z","timestamp":1405555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Perioperative anxiety is a common and undesirable outcome in pediatric surgical patients. The use of interactive tools to minimize perioperative anxiety is vastly understudied. The main objective of the current investigation was to compare the effects of a tablet\u2010based interactive distraction (<jats:styled-content style=\"fixed-case\">TBID<\/jats:styled-content>) tool to oral midazolam on perioperative anxiety. We hypothesized that the <jats:styled-content style=\"fixed-case\">TBID<\/jats:styled-content> tool was not inferior to midazolam to reduce perioperative anxiety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>108 children, ages 1\u201311\u00a0years, presenting for outpatient surgical procedures were prospectively randomized to oral midazolam (0.5\u00a0mg\u00b7kg<jats:sup>\u22121<\/jats:sup>; 20\u00a0mg max) or <jats:styled-content style=\"fixed-case\">TBID<\/jats:styled-content>. The primary outcome was the change in anxiety level from baseline to parental separation and anesthetic induction. Other data collected included emergence delirium, parental satisfaction, time\u2010to\u2010<jats:styled-content style=\"fixed-case\">PACU<\/jats:styled-content> discharge, and posthospitalization behavior.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean difference (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) in the increase of anxiety at parental separation between the <jats:styled-content style=\"fixed-case\">TBID<\/jats:styled-content> and the midazolam group was \u22129 (\u22122.6 to \u221216.4), <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.006, demonstrating superiority to midazolam group (one\u2010sided <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003). For children 2\u201311\u00a0years, the mean difference (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) in anxiety at induction was significant between the <jats:styled-content style=\"fixed-case\">TBID<\/jats:styled-content> and midazolam groups, \u221214.0 (\u22126.1 to \u221222.0), <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001. The median (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>) time\u2010to\u2010<jats:styled-content style=\"fixed-case\">PACU<\/jats:styled-content> discharge was 111 (75\u2013197) min in the midazolam group and 87 (55\u2013137) min in the <jats:styled-content style=\"fixed-case\">TBID<\/jats:styled-content> group, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.03. Decreased emergence delirium and increased parental satisfaction were also observed in the <jats:styled-content style=\"fixed-case\">TBID<\/jats:styled-content> group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A <jats:styled-content style=\"fixed-case\">TBID<\/jats:styled-content> tool reduces perioperative anxiety, emergence delirium, and time\u2010to\u2010discharge and increases parental satisfaction when compared to midazolam in pediatric patients undergoing ambulatory surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12475","type":"journal-article","created":{"date-parts":[[2014,7,18]],"date-time":"2014-07-18T04:15:29Z","timestamp":1405656929000},"page":"1217-1223","source":"Crossref","is-referenced-by-count":84,"title":["Tablet\u2010based Interactive Distraction (<scp>TBID<\/scp>) vs oral midazolam to minimize perioperative anxiety in pediatric patients: a noninferiority randomized trial"],"prefix":"10.1111","volume":"24","author":[{"given":"Samuel C.","family":"Seiden","sequence":"first","affiliation":[{"name":"Department of Pediatric Anesthesiology Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"McMullan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Ann &amp; Robert H. Lurie Children's Hospital of Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Sequera\u2010Ramos","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Gildasio S.","family":"De Oliveira","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Feinberg School of Medicine Northwestern University Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Roth","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology Ann &amp; Robert H. Lurie Children's Hospital of Chicago Northwestern University Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Rosenblatt","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Ann &amp; Robert H. 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