Effect of a game-based intervention on preoperative pain and anxiety in children: A systematic review and meta-analysis.

The trials used many different game types, durations, and times before anaesthesia, so the review cannot identify the best practical dose or timing. Anxiety was measured with several different scales, and only a subset of trials could be pooled, so the overall anxiety result depends on which scale was used. The mYPAS-SF pooled analysis did not show a statistically significant anxiety effect, which makes the anxiety finding less consistent. Pain was measured in only a small number of studies using different scales, so no reliable pooled pain estimate is available. Control groups varied in parental presence, usual medication and other distraction, so the comparison is not uniform. The review did not include postoperative follow-up data, so it cannot say how long any effect lasts after surgery. The included children varied in age, surgery type and hospital setting, so the results may not apply to every paediatric surgical population. The main pooled anxiety analysis had high heterogeneity, so the average effect may not apply to all settings.

The authors declared no conflict of interest.

Do not conclude that game-based distraction reliably reduces children's pain during anaesthesia induction. The pain evidence came from a small number of studies using different scales, and the anxiety effect was not consistent across all anxiety scales.