Browsing by Author "Spencer, Adam O."

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    Efficacy of a Preparation Intervention for the Management of Children’s Pain and Fear during Needle Procedures: Help from a Robot Named MEDi®
    (2019-06-26) Lee, Rachelle; Beran, Tanya N.; Pearson, Jacqueline Reynolds; Spencer, Adam O.
    Intravenous (IV) lines are routinely administered to pediatric patients prior to the delivery of anesthesia for elective surgery. Aside from using volatile anesthetics to aid with needle insertion, IV lines are often placed while children are awake in the operating room (OR). Although IV inductions are safe and usually well-tolerated, many still express needle-related discomfort despite the current strategies that can minimize procedural pain. This randomized-controlled, two-armed trial examined the impact of a humanoid robot (MEDi®) programmed to teach breathing strategies, on children’s ability to tolerate IV procedures. A total of 137 children (4-12 years) were recruited in Short Stay Surgery at a tertiary pediatric hospital. Patients were randomly assigned to standard care or a robot-facilitated intervention that taught breathing strategies before the IV procedure. Children’s pain and fear before, during, and after induction were rated by patients, parents, pediatric anesthesiologists, and researchers. Follow-up interviews were conducted with children and their parents to assess pain-related memories. No significant differences or changes in fear and pain were found between study groups (ps > 0.05). However, it is evident that children enjoyed interacting with MEDi® and exhibited higher use of breathing-based strategies in the OR (Fisher’s exact test (1) = 4.66, p < 0.05, Cramer’s phi = 0.21). However, several children did find the robot-facilitated preparation to be an enjoyable experience. They were also 5.04 times more likely to complete IV induction (without inhalational anesthetics), compared to standard care (Fisher’s exact test (1) = 4.85, p < 0.05, Cramer’s phi = 0.22). Finally, of those who received pre-operative coaching, some children remembered the IV induction positively and one-third of participants were able to recall meeting MEDi® at the follow-up. This study was the first to examine children’s experience of IV induction when provided support from MEDi®.