Combined of favorite cartoon stickers and fruit juices to reduce premedication anxiety in preschool children in the absence of parents

Abstract Background Several initiatives had been promoted to largely reduce transmission during the new coronavirus disease 2019 (COVID-19) World Pandemic. However, children's preoperative anxiety was more prominent when parents were advised not to stay with their children in the preoperative holding area. This study aimed to determine whether combined of favorite carton stickers and fruit juices could reduce premedication anxiety in preschool children who lacked parental presence and were scheduled for elective surgery. Methods One hundred and fourteen healthy children, aged 3–6 years, assigned to elective surgery were randomized to one of three groups: Group A (a cartoon noggin), Group B (a cartoon noggin and cartoon stickers), Group C (a cartoon noggin, cartoon stickers, and fruit juices). All groups routinely received sedative premedication (oral midazolam, 0.5mg/kg) before anesthesia induction. The modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) was used to evaluate the anxiety of each child in the following time points: T 0 (baseline anxiety: immediately after arriving in the preoperative holding area), T 1 (3 min after the interventions), T 2 (at the time of midazolam oral administration). Results There was no significant difference in mYPAS-SF scores among the three groups at T 0 ( P = 0.174). Children in Group C manifested significantly lower mYPAS-SF scores at T 1 compared with Group A and Group B ( P < 0.001 and P = 0.012), and T 2 ( P < 0.001 vs both groups). Subjects in Group B showed lower mYPAS-SF scores than that in Group A at T 1 ( P = 0.008) and T 2 ( P = 0.009). Conclusions Cartoon stickers for reducing premedication anxiety were effective, besides, the combination of cartoon stickers and fruit juices was found to be a profitable tool to reduce premedication anxiety in preschool children undergoing elective surgery. Clinical Trial Registry: A one-month, open-label study to evaluate the effect of the combination of favorite carton stickers and fruit juices on preschool children who suffer premedication anxiety. (https://www.chictr.org.cn/showproj.aspx?proj=185586) Registration number: ChiCTR2200066644.