Comparing the Effect of Acupressure and Oral Midazolam on Controlling Preoperative Anxiety in Children: A Randomized Trial

Alireza Ebrahimsoltani; Mehrdad Goudarzi; Anahid Maleki; Bita Malekianzadeh

doi:10.18502/aacc.v10i4.16257

Alireza Ebrahimsoltani Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Mehrdad Goudarzi Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Anahid Maleki Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Bita Malekianzadeh Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v10i4.16257

Keywords: Acupressure; Preoperative anxiety; Midazolam; Children; Ying tang point

Abstract

Background: Preoperative anxiety in children is a common problem that can affect the anesthesia and postoperative period. Numerous methods, mainly pharmacological ones, have been used for controlling preoperative stress. Acupressure is a simple, noninvasive, and cost-effective method that has been used as a perioperative medicine for controlling pain or preventing postoperative nausea and vomiting. The present study aimed to comparatively investigate the effect of acupressure and oral midazolam on preoperative anxiety control.

Methods: 76 patients were randomly included in the study before surgery. Whereas in one group, 0.5 mg/kg oral midazolam was prescribed 15 minutes before the induction, in another group, acupressure of EXHN-3 point was applied for 15 minutes. In both groups, the patients’ separation anxiety level, Ramsay score, recovery length, and RN satisfaction factor were recorded and compared.

Results: Children aged 1–7 years received either oral midazolam or acupressure. Although the children in the midazolam group had lower rates of preoperative anxiety and showed easier separation from their parents, the difference was not statistically significant P= (0.076). Ramsay sedation scale, was compared in the two groups. The overall difference was not statistically significant. The satisfaction of the PACU nurse was recorded using a 4-point scale. The two groups were statistically comparable in this regard (P=0.155). The only variable with a significant difference between the two groups was the mean recovery time, which was significantly shorter in acupressure group (P<0.001).

Conclusion: Acupressure can reduce preoperative anxiety in children; however, this effect is less than the effect of oral midazolam.